Atypical Presentation of Multiple Sclerosis on MRI: A Diagnostic Challenge
Main Article Content
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system, typically diagnosed based on clinical presentation and characteristic magnetic resonance imaging (MRI) findings. However, atypical MRI presentations can pose significant diagnostic challenges. This case report discusses a patient with an unusual MRI manifestation of MS, emphasizing the importance of considering MS in the differential diagnosis of atypical neuroimaging findings.
Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Filippi M, Rocca MA, Ciccarelli O. Magnetic resonance imaging of multiple sclerosis. Lancet Neurol. 2016;15(4):429-38. doi: 10.1016/S1474-4422(16)00015-5.
Filippi M, Preziosa P, Banwell BL, et al. Assessment of lesions on magnetic resonance imaging in multiple sclerosis: practical guidelines. Brain. 2019 Jul 1;142(7):1858-1875. doi: 10.1093/brain/awz144. PMID: 31209474; PMCID: PMC6598631.
Weidauer S, Raab P, Hattingen E. Diagnostic approach in multiple sclerosis with MRI: an update. Clinical Imaging. 2021 Oct 1;78:276-85.
Rocca MA, Preziosa P, Barkhof F, Brownlee W, Calabrese M, De Stefano N, Granziera C, Ropele S, Toosy AT, Vidal-Jordana À, Di Filippo M. Current and future role of MRI in the diagnosis and prognosis of multiple sclerosis. The Lancet Regional Health–Europe. 2024 Sep 1;44.
DeMaio A, Mehrotra S, Sambamurti K, Husain S. The role of the adaptive immune system and T cell dysfunction in neurodegenerative diseases. Journal of Neuroinflammation. 2022 Oct 8;19(1):251.
Wattjes MP, Ciccarelli O, Reich DS, Banwell B, de Stefano N, Enzinger C, Fazekas F, Filippi M, Frederiksen J, Gasperini C, Hacohen Y. 2021 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. The Lancet Neurology. 2021 Aug 1;20(8):653-70.
Meca-Lallana V, Berenguer-Ruiz L, Carreres-Polo J, Eichau-Madueño S, Ferrer-Lozano J, Forero L, Higueras Y, Téllez Lara N, Vidal-Jordana A, Pérez-Miralles FC. Deciphering multiple sclerosis progression. Frontiers in Neurology. 2021 Apr 7;12:608491.
Ramo-Tello C, Blanco Y, Brieva L, Casanova B, Martínez-Cáceres E, Ontaneda D, Ramió-Torrentá L, Rovira À. Recommendations for the diagnosis and treatment of multiple sclerosis relapses. Journal of Personalized Medicine. 2021 Dec 22;12(1):6.
Ananthavarathan P, Sahi N, Chard DT. An update on the role of magnetic resonance imaging in predicting and monitoring multiple sclerosis progression. Expert Review of Neurotherapeutics. 2024 Feb 1;24(2):201-16.
Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O'Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011 Feb;69(2):292-302. doi: 10.1002/ana.22366. PMID: 21387374; PMCID: PMC3084507.
Kale N. Optic neuritis as an early sign of multiple sclerosis. Eye and brain. 2016 Oct 26:195-202.
Zafar U, Habib SH, Raza SS. Identification of appropriate tools to gauge brain functions in a clinical setup of a developing country: A pilot study. Pak J Med Sci. 2023 Nov-Dec;39(6):1840-1846. doi: 10.12669/pjms.39.6.7489. PMID: 37936739; PMCID: PMC10626111.
Pittock SJ, Lucchinetti CF. Neuromyelitis optica and the evolving spectrum of autoimmune aquaporin‐4 channelopathies: a decade later. Annals of the new York Academy of Sciences. 2016 Feb;1366(1):20-39.