PMC5884398_01
Brain and spinal MRI of the patient following admission on 12 October 2014. (a) Brain T2W axial MRI (1.5 T) demonstrating the characteristic periventricular lesions of MS. (b) Magnification of brain FLAIR sagittal MRI showing involvement of the corpus callosum. (c) Sagittal T2W spinal MRI of the cervical cord with diffuse, patchy lesions. T2W: T-2 weighted; FLAIR: Fluid-Attenuated Inversion Recovery; T: Tesla.
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PMC5884398_01_CRINM2018-2768493.001.jpg
fig1
Following admission in October 2014, a repeat brain MRI with contrast was performed at 1.5 T that demonstrated recent callosal involvement (see Figure 1). T2 hyperintense lesions involving the majority of the cervical cord and T9-10 with associated atrophy (see Figure 1). These findings were discussed at the neuroradiology multidisciplinary team meeting and considered consistent with spinal MS rather than neuromyelitis optica spectrum disorder (NMOSD). This was confirmed by serology tests for anti-aquaporin 4 (AQP4) and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies, which were both negative.