Multiple Sclerosis - Advanced Case (2)

A 32 year-old man presented with double vision, slurred speech and difficulty walking. Examination showed a bilateral internuclear ophthalmoplegia, ataxia of the limbs and scanning speech.

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Axial MRI T2-weighted images: note the numerous areas of demyelination in multiple areas of the white matter. Most of the lesions are near the ventricles. Several are aligned perpendicular to the ventricles, a pattern which is highly characteristic of multiple sclerosis.

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