PMC4390163_01
Brain and spinal cord MRI of the patient with CMTX and MS and brain MRI of his first cousin with CMTX and asymptomatic diffuse CNS involvement. (a) Axial FLAIR brain MRI of the patient demonstrating periventricular lesions characteristic of MS. (b) Sagittal T2 brain MRI of the patient revealing lesions in the corpus callosum characteristic of MS. (c) Axial T2 brain MRI of the patient demonstrating a lesion in the left middle cerebellar peduncle. (d) Axial T2 cervical cord MRI of the patient demonstrating a spinal cord lesion. (e) Axial T1 with IV contrast brain MRI of the patient showing periventricular gadolinium-enhancing lesions suggesting inflammation. (f) Axial FLAIR brain MRI of the patient's first cousin revealing diffuse white matter hyperintensity more prominent posteriorly.
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fig1
Brain MRI revealed multiple focal periventricular, callosal, and brainstem lesions, some gadolinium-enhancing, strongly suggestive of MS (Figures 1(a), 1(b), 1(c), and 1(e)). T2 lesion compatible with demyelination (Figure 1(d)). The episode was treated successfully with corticosteroids. MRI (diffuse white matter hyperintensity, Figure 1(f); patient's first cousin) or clinically (extensor plantars; patient's aunt). More specifically, brain MRI of the patient's cousin revealed nonenhancing, symmetrical, diffuse white matter abnormalities, which were clearly detectable at the level of the centrum semiovale and periventricularly, were more prominent posteriorly, and involved the splenium of the corpus callosum, as previously described.