Multiple sclerosis, case 5
Clinical history
This 43-year-old man presented with a two week history of paresthesias and weakness of the right arm and leg, with diminished sensation on the left side of the body.
Lumbar puncture was performed following MRI, and the CSF demonstrated oligoclonal bands.
First MRI
Image 1: Sagittal T1WI. The spinal cord appears normal.
Image 2: Sagittal PD image. Although the contour of the cord cannot be evaluated here, abnormal signal intensity within the spinal cord is visible at the C2 level.
Image 3: Sagittal T2WI. Also nicely demonstrates high signal intensity with the posterior half of the upper cervical cord. A smaller lesion is seen in the posterior aspect of the cord at the C6 level.
Image 4: Sagittal Gd T1WI shows linear contrast enhancement of the C2 lesion.
Images 5 - 7: Axial T2WI confirm the unilateral and posterior location of the upper cervical plaque.
Images 8 - 9: Axial Gd T1WI at the level of C2. The enhancing lesion involves the posterior right side of the cord.
Images 10 - 11: Axial proton density (left) and T2WI (right) images of the brain. Multiple small areas of increased signal are seen within the white matter. (Note the classical location in the right frontal periventricular region as well as in the left middle cerebellar peduncle).
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- Multiple sclerosis
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Multiple sclerosis, case 5, Fig. 1 | | Multiple sclerosis, case 5, Fig. 2 | | Multiple sclerosis, case 5, Fig. 3 |
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Multiple sclerosis, case 5, Fig. 4 | | Multiple sclerosis, case 5, Fig. 5 | | Multiple sclerosis, case 5, Fig. 6 |
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Multiple sclerosis, case 5, Fig. 7 | | Multiple sclerosis, case 5, Fig. 8 | | Multiple sclerosis, case 5, Fig. 9 |
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Multiple sclerosis, case 5, Fig. 10 | | Multiple sclerosis, case 5, Fig. 11 | |