More MS news articles for Dec 2001

Differential diagnosis of posterior fossa multiple sclerosis lesions - neuroradiological aspects

Online publication: December 5, 2001
Neurological Sciences
Abstract Volume 22 Issue 8 (2001) pp S79-S83
A. Falini, C. Kesavadas, S. Pontesilli, M. Rovaris, G. Scotti
Department of Neuroradiology, Scientific Institute San Raffaele Hospital, Via Olgettina 60, I-20132 Milan, Italy


Various infratentorial pathological conditions can mimic multiple sclerosis (MS) both clinically and radiologically.

We review the inflammatory, vascular, neoplastic and metabolic conditions which show features similar to those of MS on magnetic resonance imaging (MRI).

Beçet's disease, Lyme disease, progressive multifocal leukoencephalopathy, neurosarcoidosis, Whipple's disease, listeria rhombencephalitis, Bickerstaff's brainstem encephalitis, vascultis due to systemic lupus erythematosus, and acute disseminated encephalomyelitis produce inflammatory lesions similar to those of MS in the brainstem and cerebellum.

Neoplastic diseases, in particular pontine gliomas and lymphomas, can mimic MS.

Vascular ischaemic lesions, either due to infarction produced by occlusion of a major posterior circulation artery or due to small vessel vasculopathy, can lead to posterior fossa lesions.

The MRI changes of central pontine myelinolysis can also mimic MS.

Diffuse axonal injury, radiation and chemotherapy induce lesions that resemble MS, however the clinical history will exclude these possibilities.

Finally, we discuss a few conditions which are similar to MS in clinical presentation but have different MRI appearances, such as brainstem cavernomas, posterior fossa tumoural lesions, aneurysms and vascular loops producing neurovascular conflicts.

Analysis of the MRI findigs with clinical history and laboratory data helps to narrow down the diagnosis of the infratentorial pathology.

© Springer-Verlag Italia 2001