Multiple Sclerosis - Initial Presentation - Case 2

A 29 year-old woman presented with right facial numbness.

Show the MS Plaques                                Show the GAD enhancement

(Left and Middle) Axial Flair MRI scans; (Right) T1-weighted axial MRI with gadolinium. Note the two lesions on Flair imaging, one in the parietal white matter and the other in the tegmentum of the pons on the right. With gadolinium, the pontine lesion enhances. This is the picture of acute demyelination. This could be an initial presentation of multiple sclerosis. However, multiple sclerosis is defined as multiple lesions in time and space. Thus, this patient would not be labeled as having multiple sclerosis unless a second attack occurred at a later time.

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