Benign versus chronic progressive multiple sclerosis: Magnetic resonance imaging features

1989 ◽  
Vol 25 (1) ◽  
pp. 74-81 ◽  
Author(s):  
R. A. Koopmans ◽  
D. K. B. Li ◽  
E. Grochowski ◽  
P. J. Cutler ◽  
D. W. Paty
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Progressive Multiple Sclerosis ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Chronic Progressive Multiple Sclerosis

Progressive Gait Difficulties

2021 ◽  
pp. 62-64
Author(s):  
I. Vanessa Marin Collazo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Progressive Multiple Sclerosis ◽  
Primary Progressive Multiple Sclerosis ◽  
Resonance Imaging ◽  
Primary Progressive ◽  
Mcdonald Criteria ◽  
Mild Reduction ◽  
History Of

A 58-year-old, right-handed man with a medical history of nephrolithiasis, essential hypertension, and type 2 diabetes sought care for a 6-year history of gait impairment. Initially, he noted subtle left foot and ankle weakness with associated falls that progressed over time. Two to 3 years later he again noted progressive left leg weakness and new arm weakness. Subsequently, progressive pain developed on the soles of his feet in addition to edema with erythematous discoloration around the left ankle and foot. On neurologic examination, he was found to have mild upper motor neuron pattern weakness in the left arm and leg, most pronounced in the left hand finger extensor and left hip flexion and abduction. Left patellar reflex was brisk, and there was an extensor Babinski sign on the left. There was mild reduction in pinprick sensation in both feet. His gait was spastic with left leg circumduction. Magnetic resonance imaging of the brain showed left-sided predominant periventricular and subcortical T2 fluid-attenuated inversion recovery hyperintensities. Magnetic resonance imaging of the cervical and thoracic spinal cord showed intramedullary cord T2 signal hyperintensities, eccentrically located on the left at C3, C5, C6, on the right at C7 to T1, and centrally at T4/T5 and T8/T9. A diagnosis of primary progressive multiple sclerosis was made. The patient met the 2017 McDonald criteria for primary progressive multiple sclerosis. After the diagnosis was confirmed and comprehensive education about the disease and the role of disease-modifying therapy was discussed with the patient, he was started on ocrelizumab. Gabapentin was started for management of painful foot paresthesias. Vitamin D3 supplementation was started. Physical therapy was also initiated. Multiple sclerosis is a chronic immune-mediated demyelinating disease of the central nervous system and is the leading cause of disability in the young population. Approximately 1 million people in the United States currently have multiple sclerosis.

Clinical and Magnetic Resonance Imaging Predictors of Disability in Primary and Secondary Progressive Multiple Sclerosis

1996 ◽  
Vol 1 (4) ◽  
pp. 218-222 ◽  
Author(s):  
NA Losseff ◽  
DPE Kingsley ◽  
WI McDonald ◽  
DH Miller ◽  
AJ Thompson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Initial Study ◽  
Progressive Multiple Sclerosis ◽  
Resonance Imaging ◽  
Secondary Progressive ◽  
Short Period ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study

The role of magnetic resonance imaging (MRI) in predicting disability in multiple sclerosis (MS) remains unclear. In this study 21 patients with primary and secondary progressive MS were reviewed 5 years following a serial MRI study of 6 months duration. In the secondary progressive group (n=11) there was a significant relationship between the occurrence of enhancing lesions and clinical relapses during the initial 6 months and increase in diability 5 years later. For both groups change in disability over the initial study period was predictive of outcome. These results suggest that the presence and frequency of gadolinium enhancement (a marker of inflammation) and changes in disability over a short period are predictive of future deterioration in progressive patients.

Diagnosis of Multiple Sclerosis

2016 ◽  
Author(s):  
Loren A. Rolak
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Imaging Study ◽  
Progressive Multiple Sclerosis ◽  
Primary Progressive Multiple Sclerosis ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mcdonald Criteria ◽  
Highly Sensitive

Because no laboratory test or imaging study is both highly sensitive and highly specific for multiple sclerosis, some uncertainty often accompanies the diagnosis. Various guidelines have been developed to assist the clinician, including the much-modified and commonly used McDonald criteria. Typical features of the history, the physical examination, and magnetic resonance imaging findings usually allow for a secure diagnosis. However, limitations inherent in any testing modality still pose challenges. This is especially true for diagnosis of primary progressive multiple sclerosis because the sensitivity and specificity of the evaluations are lower.

Magnetic resonance imaging predictors of disability in primary progressive multiple sclerosis: a 5-year study

2004 ◽  
Vol 10 (4) ◽  
pp. 398-401 ◽  
Author(s):  
V L Stevenson ◽  
G T Ingle ◽  
D H Miller ◽  
A J Thompson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Ventricular Volume ◽  
Progressive Multiple Sclerosis ◽  
Primary Progressive Multiple Sclerosis ◽  
Resonance Imaging ◽  
Primary Progressive ◽  
Therapeutic Trials ◽  
Rate Of Increase

Magnetic resonance imaging (MRI) has become an accepted tool for monitoring therapeutic trials in relapsing-remitting and secondary progressive multiple sclerosis (MS); it is however unclear whether such MRI markers are equally applicable to primary progressive MS (PPMS). Forty-two patients with PPMS were reviewed five years after commencing a two-year MRI and clinical study. Clinical measures recorded at baseline and five years included both the Expanded Disability Status Scale and the MS functional composite. MRI data collected at baseline and two years included T1 and T2 lesion loads, the number of new brain and cord lesions, and measures of both brain and cord atrophy. The study demonstrated that both the number of new T2 lesions and rate of increase in ventricular volume over two years were modestly predictive of subsequent disease progression and therefore may be useful tools in the testing of new therapeutic agents in PPMS.

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