Other disturbances of skin sensation [R20.8], Reason for Study: ^Reason: Demyelination? Structural abnormality? History: R side facial numbness, previous MRI brain with R periventricular white matter lesions There are multifocal high signal intensity lesions on T2/FLAIR involving bilateral corpus callosum, periventricular white matter especially bilateral trigone, bilateral temporal lobe white matter and right middle cerebellar peduncle and right anterosuperior aspect of the pons. These lesions are discrete not associated with surrounding edema or mass effect. Constellation of these findings suggest demyelinating disease such as multiple sclerosis. Differential diagnosis include ADEM and migraine related white matter lesions though less likely. To evaluate the activity of these lesion, if clinically indicated, contrast enhanced MRI can be considered.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Mucosal thickenings are seen on bilateral maxillary sinuses and ethmoid sinus.
1. Multifocal various sized T2/FLAIR high signal intensity lesions suggesting demyelinating disease such as multiple sclerosis. Differential diagnosis include ADEM and migraine related white matter lesion although less likely.2. No evidence of acute ischemic or hemorrhagic lesion.