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This is a special MRI sequence that shows the myelin's percentage of water content. [25] Pattern III lesions, including Baló lesions, have a specific initiation pattern under MRI (MRILIP) consisting in showing Gadolinium enhancement before FLAIR MRI appearance. [26] Under 7-Tesla MRI Ball lesions show a center vein, like in MS. [27]
The importance of vascular misbehaviour in MS pathogenesis has also been independently confirmed by seven-tesla MRI. [96] It is reported that a number of studies have provided evidence of vascular occlusion in MS, which suggest the possibility of a primary vascular injury in MS lesions or at least that they are occasionally correlated.
Unusual types of MS have been described; these include Devic's disease, Balo concentric sclerosis, Schilder's diffuse sclerosis, and Marburg multiple sclerosis. There is debate on whether they are MS variants or different diseases. [31] Multiple sclerosis behaves differently in children, taking more time to reach the progressive stage. [5]
Together with MRI, magnetic resonance spectroscopy allows to see the biochemical composition of the lesions, which shows at least two different patterns [201] Currently as of 2014, the MRI studies have led to the proposal of four MRI phenotypes, [202] though both the classification and the relationship with the pathology remains controversial.
Currently, routine clinical follow-up and MRI neuroimaging surveillance is the standard by which patients are observed. [4] While treatment of MS disease modifying therapies have been given to some individuals with RIS, the majority opt for active surveillance and the appearance of clinical symptoms before commencing treatment, [5] as treatment is considered controversial.
Main symptoms of multiple sclerosis Symptoms and findings in multiple sclerosis. Multiple sclerosis can cause a variety of symptoms varying significantly in severity and progression among individuals: changes in sensation (hypoesthesia), muscle weakness, abnormal muscle spasms, or difficulty moving; difficulties with coordination and balance; problems in speech or swallowing (), visual ...
Balo concentric sclerosis, an unusual presentation of plaques forming concentric circles, which can sometimes get better spontaneously. Schilder disease or diffuse myelinoclastic sclerosis: is a rare disease that presents clinically as a pseudotumoural demyelinating lesion; and is more common in children. [7] [8]
Currently the best predictor for clinical multiple sclerosis is the number of T2 lesions visualized by MRI during the CIS, but it has been proposed to complement it with MRI measures of BBB permeability [97] It is normal to evaluate diagnostic criteria against the "time to conversion to definite".