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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 optic neuritis have white matter lesions consistent with multiple sclerosis.
The McDonald criteria states that patients with multiple sclerosis should have lesions which are disseminated in time (DIT) and disseminated in space (DIS), i.e. lesions which have appeared in different areas in the brain and at different times. [90] Below is an abbreviated outline of the 2017 McDonald Criteria for diagnosis of MS.
* 2 or more objective clinical lesions None; clinical evidence will suffice (additional evidence desirable but must be consistent with MS) * 2 or more attacks * 1 objective clinical lesion (as well as clear-cut historical evidence of a previous attack involving a lesion in a distinct anatomical location) None. * 2 or more attacks
These atypical lesion characteristics include a large intracranial lesion of size greater than 2.0 cm with a mass effect, edema and an open ring enhancement. A mass effect is the effect of a mass on its surroundings, for example, exerting pressure on the surrounding brain matter. Edema is the build-up of fluid within the brain tissue.
Radiologically isolated syndrome (RIS) is a clinical situation in which a person has white matter lesions suggestive of multiple sclerosis (MS), as shown on an MRI scan that was done for reasons unrelated to MS symptoms. The nerve lesions in these people show dissemination in space with an otherwise normal neurological examination and without ...
Multiple sclerosis is a disease that causes the immune system to attack the central nervous system, leading to communication problems between the brain and the rest of the body.
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