Multiple sclerosis with active lesions

Case contributed by Ahmed Abdrabou


Follow up of a known MS patient with progressive parathesia of both upper limbs.

Patient Data

Age: 20 years old
Gender: Female

Multiple white matter oblong shape plaques oriented perpendicular to the corpus callosum (Dawson fingers) and display bright signal in T2, FLAIR and DWI. One of them shows faint enhancement in post contrast scan.

A well defined oval shape right lateral intramedullary plaque opposite C2 and parallel to the spinal axis, display bright signal in T2 with moderate enhancement post contrast

Case Discussion

Multiple sclerosis is a demyelinating disease characterized by attacks of remission and exacerbation. Its etiology now is believed to be due to perivenular inflammation with destruction of the myelin sheath around the neurons hence the plaque like lesions directed perpendicular to the corpus callosum. DWI and post contrast study can aid in identifying the possibly active plaque.

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