Tumefactive multiple sclerosis

Case contributed by Abdallah Al Khateeb
Diagnosis almost certain


Recurrent seizures.

Patient Data

Age: 20 years
Gender: Male

Two periventricular low T1, high T2 lesions, which show no diffusion restriction and little surrounding edema. The one on the right shows incomplete or open ring pattern of enhancement.

Case Discussion

Ring enhancing brain lesions have a relatively wide differential diagnosis which is geared by many variables. The mnemonic MAGIC DR is used to help remember them.

This tumor like lesion shows the typical open ring sign of enhancement that strongly suggests a demyelinating disease.

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