Multiple sclerosis (MS): inflammatory MRI differentials

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Multiple sclerosis (MS): inflammatory MRI differentials. The lesions are not adjacent to the body of the lateral ventricle.

Neuromyelitis optica (NMO)

  • The lesions are not adjacent to the body of the lateral ventricle
  • There are no S-shaped subcortical U-fibre lesions
  • There are no Dawson's finger-type lesions

Progressive multifocal leukoencephalopathy (PML)

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Acute disseminated encephalomyelitis (ADEM)

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Susac’s syndrome

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Behcet’s disease

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Other inflammatory MRI differentials

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Reasons for MRI misdiagnosis of MS

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References

  1. Charil A, Yousry TA, Rovaris M. MRI and the diagnosis of multiple sclerosis: expanding the concept of “no better explanation”. Lancet Neurol 2006; 5:841-852.
  2. Falini A, Kesavadas C, Pontesilli S, Rovaris M, Scotti G. Differential diagnosis of posterior fossa multiple sclerosis lesions-neuroradiological aspects. Neurol Sci 2001; 22:S79-S83.
  3. Bastianello S, Pichiecchio A, Spadaro M, et al. Atypical multiple sclerosis: MRI findings and differentials. Neurol Sci 2004; S356-S360.
  4. Juryńczyk M, Tackley G, Kong Y, et al. Brain lesion distribution criteria distinguish MS from AQP4-antibody NMOSD and MOG-antibody disease. JNNP 2016; pii: jnnp-2016-314005 (Epub ahead of print).
  5. Wijburg MT, Witte BI, Vennegoor A, et al. MRI criteria differentiating asymptomatic PML from new MS lesions during natalizumab pharmacovigilance. JNNP 2016; 87:1138-1145. 
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