By Charles M. Poser
This illustrated pocketbook offers an simply obtainable precis of key matters in terms of diagnosing a number of sclerosis and dealing with sufferers at various levels of the disease.
summary: This illustrated pocketbook provides an simply obtainable precis of key matters when it comes to diagnosing a number of sclerosis and coping with sufferers at various phases of the sickness
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Extra info for An illustrated pocketbook of multiple sclerosis
In a surprisingly large number of MS patients, cervical cord plaques can be seen adjacent to areas of compression—whether actual, potential or intermittent—by spondylosis and/or herniated disks (Figures 40– 42). It is possible that pressure from such extrinsic lesions may aggravate the underlying MS in addition to the myelopathic effects they produce. Obtaining lateral MRI views of the neck in flexion may reveal effacement of the ventral subarachnoid space or even cord compression that is not evident with the neck in a normal position, in particular in patients who have a neck injury.
The cord is shoved backwards, causing narrowing of the subarachnoid space posteriorly from C3–4 downwards. The axial view of C4–5 shows compression of the cord clearly anisotrophy and N-acetyl-aspartate spectra with chemical shift imaging, or the presence of ‘black holes’ with T1-weighting). Imaging differential diagnoses Many diseases of the nervous system that result in white-matter lesions seen by MRI are often erroneously diagnosed as MS. By far the most common of these is acute disseminated encephalomyelitis (ADEM) (Figure 45).
It is unusual to find an enhancing lesion that is not visible on the T2-weighted image (Figure 43). Treatment decisions of exacerbations should be based on clinical considerations. At present, the reliability of evaluating long-term treatment by serial gadolinium-enhanced MRI has not been completely settled. While enhancement, which reflects the inflammatory reaction, and blood-brain barrier alteration, are often considered to be a sign of activity of the disease, its actuality is deceptive: blood-brain barrier alterations may have been present for 3 months or longer.
An illustrated pocketbook of multiple sclerosis by Charles M. Poser