Ces radiol. 2020, 74(4):279-283 | DOI: 10.55095/CesRadiol2020/042

Radiologically isolated syndrome and Multiple Sclerosis - case reportCase report

Monika Daňová¹, Eleonóra Klímová², Anna Cvengrošová²

¹ ProMagnet, s. r. o., Magnetická rezonancia FNsP J. A. Reimana, Prešov

² Klinika neurológie FZO PU a Neurologické oddelenie FNsP J. A. Reimana, Prešov

Multiple Sclerosis is an immune-mediated inflammatory and neurodegenerative disease of the Central Nervous System. The diagnosis of Multiple Sclerosis is based on the synthesis of the clinical picture and the finding on magnetic resonance imaging (MRI), supported by the finding in the cerebrospinal fluid, as well as the other neurophysiological and laboratory findings at the exclusion of other alternative diagnoses. Lublin et al. defined two main phenotypes of MS, namely relapsing-remitting MS and progressive MS, which are further subdivided according to disease activity (clinical/or radiological). Radiologically isolated syndrome, defined by Okuda et al. as a condition without obvious clinical signs or their remitting history but with brain MRI findings typical of Multiple Sclerosis, was not included in the spectrum of Multiple Sclerosis phenotypes due to the lack of clinical symptoms of the disease and the fact, that MRI findings themselves are not sufficient to the diagnose of Multiple Sclerosis.
So far, there is still little information on this syndrome and the main concern of physicians is to determine the risk of developing the definite Multiple Sclerosis for patient with radiologically isolated syndrome. Patients with a higher "lesions load" on the brain MRI, an active lesion, a spinal cord lesion or a positive finding in the cerebrospinal fluid are particularly more likely to have it developed. In the present case report the authors also discuss the pitfalls and controversies of this demanding radiological-clinical entity in practice.

Keywords: radiologically isolated syndrome, magnetic resonance imaging, multiple sclerosis

Accepted: December 15, 2020; Published: December 1, 2020  Show citation