Multiple sclerosis, solitary sclerosis or something else?
BACKGROUND
Inflammatory demyelinating diseases of the central nervous system represent a wide spectrum of entities and their classification cannot currently be regarded complete.


OBJECTIVE
Our aim is to describe a series of patients presenting with progressive myelopathy associated to a single demyelinating lesion of the spinal cord.


METHODS
We identified the patients affected by chronic progressive spinal cord dysfunction related to a single spinal cord lesion not satisfying the diagnostic criteria for any of the currently defined diseases.


RESULTS
Seven females and one male were included. The median age at onset of symptoms was 53 years (range 42-68) and the median follow-up was 8 years (range 5-12). Brain and spinal magnetic resonance imaging (MRI) scans detected only one single, circumscribed, T2 hyperintense, non-longitudinally extensive lesion at level of cervico-medullary junction or cervical cord, in the absence of Gadolinium enhancement or swelling. Cerebrospinal fluid (CSF) examination displayed neither oligoclonal bands nor raised IgG index. A response to immunosuppressive agents was observed in some of the patients. Serial control brain and spinal MRI did not reveal accumulation of new lesions.


CONCLUSIONS
New entities or variants should be included among the inflammatory demyelinating diseases of the central nervous system, and their characterization may have relevant prognostic and treatment implications.
Neurological Clinic, Marche Polytechnic University, Ancona, Italy alfierelattanzisimona@gmail.com.
Simona
S
Lattanzi
Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Francesco
F
Logullo
Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Paolo
P
Di Bella
Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Mauro
M
Silvestrini
Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Leandro
L
Provinciali
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D020278:Demyelinating Autoimmune Diseases, CNS / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology* / Q000503:physiopathology; D009188:Myelitis, Transverse / Q000473:pathology* / Q000503:physiopathology; D013116:Spinal Cord / Q000473:pathology* / Q000503:physiopathology
Multiple sclerosis; transverse myelitis