Sequential magnetic resonance imaging follow-up of multiple sclerosis before the clinical phase.
There is much evidence of the importance of the preclinical phase of multiple sclerosis (MS). However, apart from a recent report of the incidental discovery of a case of primary progressive MS, there are no data on the sequential magnetic resonance imaging (MRI) follow-up of patients before the clinical phase. We report the incidental discovery of white matter changes on MRI and their follow-up in a patient three years before the first neurological event (optic neuritis). A 34-year-old woman presented with headaches and depression after her young daughter had been involved in a car accident and spent two weeks in intensive care. The woman's general practitioner performed a brain MRI, which revealed multiple T2-weighted hypersignals suggesting MS. During the next three years, clinical examination remained normal but we observed new T2 lesions and/or new enhanced T1 lesions after gadolinium infusion on the four successive MRIs. Thirty-seven months after the first MRI, the patient developed a right optic neuritis. The diagnosis of MS was made according to space and time dissemination on MRI criteria. We proposed a treatment with Interferon Beta 1a (Avonex).
de Seze
J
J
Department of Neurology, University of Lille, Lille, France. j-deseze@chru-lille.fr
Vermersch
P
P
D000328:Adult; D001921:Brain / Q000473:pathology*; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000473:pathology*