summary: After a first inflammatory-demyelinating episode of the central nervous system, there are two main options for the clinical evolution that follows. Either the inflammatory-demyelinating process in the brain may continue (appearance of relapses and/ or progression of disability) with a diagnosis of multiple sclerosis, or the process can stop (with more episodes being unlikely) in a process called acute disseminated encephalomyelitis (ADEM). The differentiation between these two entities is crucial, since their management and prognosis are completely different. However, despite the different clinical features, the differentiation between them can be difficult. The authors of this study have found different patterns of demyelination for people with MS (confluent demyelination) and people with ADEM (perivenous demyelination). These findings contribute to the understanding of these two diseases and may help us differentiate them.

authors: Young NP, Weinshenker BG, Parisi JE, Scheithauer B, Giannini C, Roemer SF, Thomsen KM, Mandrekar JN, Erickson BJ, Lucchinetti CF

source: Brain. 2010 Feb 3

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category: Pathology

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