Attacks of upper and lower limbs parathesia and paraparesis and diplopia
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Multiple bilateral corona radiata, centrum semiovale and left internal capsule white matter oval shaped variable sized plaques most of them are perpendicular to the corpus callosum (Dawson fingers). They display hyperintense signal in T2 and FLAIR with restricted diffusion on DWI (confirmed on ADC) suggesting recent activity)
This patient has an established diagnosis of multiple sclerosis with current activity (Clinical and MR findings)
Multiple sclerosis is a common demyelinating disease that usually affects middle age females and characterizes by attacks of remission and exacerbation. Activity of the plaques can be assessed by DWI manifested by restricted diffusion of water molecules or by post contrast study which reveals incomplete ring of enhancement corresponding to active inflammation. This patient responds well to IV corticosteroids and was brought to remission.
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- Filippi M, Rocca MA. MR imaging of multiple sclerosis. Radiology. 2011;259 (3): 659-81. Radiology (full text) - doi:10.1148/radiol.11101362 - Pubmed citation