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Multiple Sclerosis
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Article

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

J.N.P. Zwemmer1*, J.C.J. Bot2, B. Jelles1, Frederik Barkhof2, C H Polman1, and F Barkhof

1 1Department of Neurology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
2 2Department of Radiology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

* To whom correspondence should be addressed.


  Abstract

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.

Key Words: MRI; primary progressive multiple sclerosis

First published on January 21, 2008, doi:10.1177/1352458507084591

Multiple Sclerosis 2008;14:428.

A more recent version of this article appeared on April 1, 2008

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