Image IQ: Patient with Vertigo, Episodic Dysarthria and Lower-Left Extremity Weakness

June 25, 2018

Can you properly diagnose this 30-year-old female?

30-year-old female who presented with a three-week history of vertigo, episodic dysarthria, left lower-extremity weakness.

Imaging demonstrates peripherally isointense and internally hypointense T1 signal of the deep and subcortical white matter. They do not restrict diffusion.  SWI demonstrates no suggestion of hemorrhage or calcification.  The lesions are T2/FLAIR hyperintense with perilesional vasogenic edema and smooth peripheral enhancement.

What's your diagnosis?