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The damaged white matter is known as "Normal-appearing white matter" (NAWM) and is where lesions appear. [10] These lesions form in NAWM before blood–brain barrier breakdown. [64] BBB can be broken centripetally (the most normal) or centrifugally. [65] Several possible biochemical disrupters were proposed.
Most of the brain in MS is unaffected. Though obviously normal white matter appears normal under MRI, so does the NAWM white matter described in the next section. To establish a difference, normal white matter is named Non-lesional white matter (NLWM) [134] This normal white matter is reported to be around 56% of the total WM of the patients. [135]
They do not spread into the subcortical white matter and never show gadolinium enhancement. Over a one-year period, CLs can increase their number and size in a relevant proportion of MS patients, without spreading into the subcortical white matter or showing inflammatory features similar to those of white matter lesions. [29]
Multiple sclerosis (MS) is an autoimmune disease resulting in damage to the insulating covers of nerve cells in the brain and spinal cord. [3] As a demyelinating disease , MS disrupts the nervous system's ability to transmit signals , resulting in a range of signs and symptoms , including physical, mental , and sometimes psychiatric problems.
Multiple sclerosis with cavitary lesions: Atypical multiple sclerosis cases similar to vanishing white matter disease but etiologically different from both. [77] Lesions similar to vanishing white matter disease [77] Leukodystrophy-like MS. Other radiological classification of atypical lesions proposes the following four subtypes: [78] infiltrative
Up to 50% of patients with MS will develop an episode of optic neuritis and 20% of the time optic neuritis is the presenting sign of MS. The presence of demyelinating white matter lesions on brain MRIs at the time of presentation for optic neuritis is the strongest predictor in developing clinical diagnosis of MS. Almost half of patients with ...
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