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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Acute demyelinating lesions with restricted diffusion in multiple sclerosis.

Konstantin E Balashov1, Eric Lindzen

  • 1Department of Neurology, UMDNJ, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA. kbalashov@yahoo.com

Multiple Sclerosis (Houndmills, Basingstoke, England)
|April 24, 2012
PubMed
Summary

Acute demyelinating lesions exhibiting restricted diffusion (ADLRD) in multiple sclerosis (MS) may represent a new variant. These ADLRD present diagnostic challenges, particularly in differentiating from stroke in young adults.

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimmunology

Background:

  • Typical acute demyelinating lesions in relapsing-remitting multiple sclerosis (RRMS) show vasogenic edema and increased diffusion on MRI.
  • Acute ischemic lesions typically present with cytotoxic edema and restricted diffusion.
  • Recent reports indicate some acute demyelinating lesions in MS can exhibit restricted diffusion (ADLRD).

Purpose of the Study:

  • To assess the morphology, distribution, signal characteristics, and temporal changes of nine ADLRD.
  • To correlate clinical findings with ADLRD.
  • To review previously published ADLRD case reports.

Main Methods:

  • Retrospective case series conducted at two academic centers.
  • Compared MRI characteristics of nine ADLRD in six RRMS patients.
  • Controlled comparison with typical active, contrast-enhancing lesions in RRMS patients.

Main Results:

  • ADLRD size was comparable to typical MS lesions.
  • Periventricular location and faint T2-weighted signal were more common in ADLRD.
  • Two patients developed new ADLRD on follow-up scans.

Conclusions:

  • ADLRD appear to be a novel variant of MS lesions.
  • Restricted diffusion in ADLRD poses a diagnostic challenge for stroke in young adults.
  • The underlying pathogenesis of ADLRD requires further investigation.