Objective : We present two patients with clinical course, MRI findings, electrophysiologic studies, and brain biopsy
not suggestive of any previously described demyelinating disorder.
Materials and Method : One with history of optic neuritis became comatose in a steady pattern within 3.5 months
and died. The other who developped left hemiplegia showed multiple ring-enhanced nodular lesions in MRI and
good response to steroid and azothioprine.
Discussion : The assesment of the patient suspected of having MS remains a clinical challenge in which sound
judgement is of paramount importance. The diagnosis was established by the clinical course, the neuroradiological
findings, and the result of brain biopsy.
Conclusion : We suggest that several steps should be followed by a neurologist when first confronted by a patient
suspected of having Multiple Sclerosis.
Key Words : Atypical, Demyelinating Disease, Multiple Sclerosis
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