Multiple sclerosis [G35], Reason for Study: ^Reason: MS; f/u progression History: weakness; paresthesias Brain MRIThere are multifocal bihemispheric supra and infratentorial FLAIR high signal intensity lesions.Comparing to prior scan, there are more FLAIR high signal intensity lesions on current scan. In particular, the right superior parietal lobule and right periventricular white matter especially along the right lateral ventricle occipital horn.Signal intensity level of each lesion appears to be more prominent on current scan, but this could be related to imaging technique, thus the significance of this finding is hard to determine.On Gad enhanced scan, there are multiple various sized enhancing nodules at bilateral centrum semiovale, periventricular white matter, frontal deep white matter and left cerebellar hemisphere indicating active inflammatory lesions.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Cervical Spine MRIThere are multifocal T2 high signal intensity lesions on cervical spinal cord. In particular, at the level of C4 and C5. The C4 level lesion shows cord swelling as well. These findings are consistent with spinal cord involvement by demyelinating disease such as multiple sclerosis. On Gad enhanced scan, the lesions show enhancement indicating active inflammation.There is normal cervical lordosis. The cranial-cervical junction is normal. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance.The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal stenosis, cord compression or myelopathy.
1. Interval progression of multiple sclerosis lesions with evidence of active inflammation as described above.2. Cervical spinal cord involvement of multiple sclerosis especially at the level of C4 and C5 with evidence of active inflammation. 