Headache, Seizure, Sensory Changes

32-year-old patient presented with complaint of headache, seizures, and sensory changes.

Figure 1A. FLAIR image shows periventricular hyperintense foci.

Figure 1B. FLAIR image shows periventricular hyperintense foci.

Figure 1C. FLAIR image shows parieto-occipital subcortical white matter hyperintense to foci.

Figure 1D. FLAIR image shows parieto-occipital subcortical white matter hyperintense to foci.

Figure 1E. FLAIR image shows parieto-occipital subcortical white matter hyperintense to foci.

Figure 1F. FLAIR image shows diffuse hyperintensity of medulla and cord.

Figure 2. T2W image shows diffuse hyperintensity of medulla and cord.

Figure 3A. Contrast T1W images show no enhancement.

Figure 3B. Contrast T1W image shows no enhancement.

CEMR showed multiple deep periventricular hyperintense foci on T2W and FLAIR images

Demyelinating disease is incorrectly often equated to multiple sclerosis.

Primary demyelinating disorders include clinically isolated syndrome and MS.

In most cases toxic and metabolic disease, which affect the white matter are considered separately.

Toxic diseases include central pontine myelinolysis and chemotherapy.

Although not referred to as demyelination, many processes which cause ischemia lead to demyelination.