Multiple sclerosis is a relatively common acquired chronic relapsing demyelinating disease involving the central nervous system, and is the second most common cause of neurological impairment in young adults, after trauma. Characteristically, and by definition, there is dissemination in space (i.e. multiple lesions in different regions of the brain; periventricular, juxtacortical, brainstem, and spinal cord ) and also in time (i.e. lesions occur at different times). The presentation is usually between adolescence and the sixth decade, with a peak at approximately 35 years of age. There is a strong female predilection with a F: M ratio of approximately 2:1. 

The above MRI findings demonstrate the characteristic black holes on T1 and Dawson fingers on T2/FLAIR sequences. The patient subsequently had CSF analysis which showed oligoclonal bands.