title: At the heart of primary progressive multiple sclerosis: three cases with diffuse MRI abnormalities only.
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.
authors.affiliation: Department of Neurology, MS Center, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. jnp.zwemmer@vumc.nl
authors.forename: J N P
authors.initials: JN
authors.lastname: Zwemmer
authors.forename: J C J
authors.initials: JC
authors.lastname: Bot
authors.forename: B
authors.initials: B
authors.lastname: Jelles
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
authors.forename: C H
authors.initials: CH
authors.lastname: Polman
mesh_terms: D000328:Adult; D002490:Central Nervous System / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology