White Matter Diseases Flashcards
Variants of MS
Balo disease
Devic disease
Schilder disease
Marburg disease
Give examples of secondary demyelinating diseases
ADEM HIV-associated encephalitis PML SSPE Binswanger disease CADASIL Postanoxic encephalopathy PRES Osmotic demyelination or CPM Alcohol Radiation Marchiafava-Bignami disease Drugs Toxins Diffuse axonal injury
Give examples of dysmyelinating diseases
Alexander disease Krabbe disease Sudanophilic leukodystrophy Pelizaeus-Merzbacher disease Canavan disease Metachromatic leukodystrophy Adrenoleukodystrophy
Lab tests in MS
Elevated CSF Ig G index in 70%
Elevated oligoclonal bands in 90%
Most common course of MS
Relapsing remitting
85% of cases
Primary progressive MS differs from secondary progressive MS in
Smaller lesions
Fewer new lesions
Fewer enhancing lesions
What’s the monosymptomatic patient’s presentation in MS
Single episode of neurologic deficit such as:
Optic neuritis
Transverse myelitis
Brainstem syndrome
Significance of black holes lesions
Low T1 lesions associated with greater myelin loss
What to consider in reporting MS lesions?
Supratentorial Infratentorial Spinal Enhancement Juxtacortical Black holes (Low T1)
Predilection of MS lesions
Periventricular Corpus callosum Subcortical region Posterior fossa Cervical spinal cord
Most specific lesions for MS
Lesions at the callosum-septal interface
Ovoid lesions rather than rounded ones
Best to asses posterior fossa MS lesions
T2
Not FLAIR!
Features of Tumefactive MS that help differentiating it from tumors
Clinical data Other white matter lesions Leading edge enhancement Open ring enhancement No increased perfusion Veins course through it rather being displaced by it
Explain T1 hyperintensity in MS lesions
Hemorrhage Myelin catabolites Protein Fat Free radicals
Low T1 and T2 signal in the basal ganglia and thalami is seen in
MS
Parkinson’s
Multisystem disease
Due to iron deposition
