Diagnosis: Other convulsions Multiple sclerosisClinical question: H/O MS, NEW SEIZURE The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of multiple periventricular white matter lesions as well as lesions in the internal capsules, brainstem and cerebellum hemisphere and subcortical white matter which to a large degree were present on the previous exam and have not changed substantially in extent.No abnormal enhancing lesions are appreciated within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is redemonstration of a moderate to marked degree of periventricular, subcortical, internal and external capsule, brainstem and cerebellar lesions which are compatible the patient's diagnosis of a demyelinating disorder. There is not appear to be a substantial change in the extent or distribution of these lesions when compared to the prior exam from last year.2.No abnormal enhancing lesions are appreciated intracranially to suggest acute demyelinating plaque at this time.