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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282XOn-line version ISSN 1678-4227

Abstract

ROCHA, Antonio Jose da; LITTIG, Ingrid Aguiar; NUNES, Renato Hoffmann  and  TILBERY, Charles Peter. Central nervous system infectious diseases mimicking multiple sclerosis: recognizing distinguishable features using MRI. Arq. Neuro-Psiquiatr. [online]. 2013, vol.71, n.9B, pp.738-746. ISSN 0004-282X.  https://doi.org/10.1590/0004-282X20130162.

The current diagnostic criteria for multiple sclerosis (MS) confirm the relevant role of magnetic resonance imaging (MRI), supporting the possibility of characterizing the dissemination in space (DIS) and the dissemination in time (DIT) in a single scan. To maintain the specificity of these criteria, it is necessary to determine whether T2/FLAIR visible lesions and the gadolinium enhancement can be attributed to diseases that mimic MS. Several diseases are included in the MS differential diagnosis list, including diseases with exacerbation, remitting periods and numerous treatable infectious diseases, which can mimic the MRI features of MS. We discuss the most relevant imaging features in several infectious diseases that resemble MS and examine the primary spatial distributions of lesions and the gadolinium enhancement patterns related to MS. Recognizing imaging "red flags" can be useful for the proper diagnostic evaluation of suspected cases of MS, facilitating the correct differential diagnosis by assessing the combined clinical, laboratory and MR imaging information.

Keywords : central nervous system infections; multiple sclerosis; differential diagnosis; magnetic resonance imaging; MRI; infecções do sistema nervoso central; esclerose múltipla; diagnóstico diferencial; imagem por ressonância magnética; RM.

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