Multiple sclerosis with weakness. Follow up progression. There are scattered punctate and confluent areas of abnormal T2/FLAIR hyperintensity within the supratentorial periventricular and subcortical white matter in a pattern compatible with known demyelinating disease. There are multiple new foci of T2/FLAIR signal abnormality such as the left superior frontal gyrus subcortical white matter, bilateral frontal and parietal corona radiata, and left anterior temporal subcortical white matter. Multiple lesions with T1 hypointensity again seen. There is mild volume loss involving the corpus callosum, similar to prior. There is no evidence of intracranial mass or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable.
Interval progression of known demyelinating disease compared to 4/25/2013 with multiple new lesions as described above.