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Multiple Sclerosis
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At the heart of primary progressive multiple sclerosis: three cases with diffuse MRI abnormalities only

JNP Zwemmer

Department of Neurology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands, jnp.zwemmer{at}vumc.nl

JCJ Bot

Department of Radiology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

B. Jelles

Department of Neurology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

F. Barkhof

Department of Radiology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

CH Polman

Department of Neurology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

We present three patients with a clinical course and cerebrospinal fluid findings consistent with a diagnosis of primary progressive multiple sclerosis (PPMS). Extensive and repeated magnetic resonance imaging (MRI) examinations showed only diffuse abnormality in brain and spinal cord, but no focal lesions. We propose that these cases represent the most pure form of PPMS, even though according to currently applied criteria this diagnosis can not be made in the absence of focal lesions on MRI. Multiple Sclerosis 2008; 14: 428—430. http://msj.sagepub.com

Key Words: MRI • primary progressive multiple sclerosis

This version was published on April 1, 2008

Multiple Sclerosis, Vol. 14, No. 3, 428-430 (2008)
DOI: 10.1177/1352458507084591
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