26 year old civil servant, presented with a 1 month history of B/L numbness in hands and feet, fatigue and generalized weakness. She had noticed some blurred vision over the previous 2 weeks. She recalled experiencing similar but milder symptoms during the previous summer. Which of the following is most appropriate diagnosis?
Clinical scenario and imaging points towards diagnosis of Multiple sclerosis(MS) 1st image shows open ring/ horse shoe enhancement(suggestive of demyelination) and a T2 weighted image showing multiple hyper intense round to oval shaped lesions lying perpendicular to ventricular margin (Dawson's finger sign). All the options given are demyelinating disorders. Can be differentiated depending upon different presentations and imaging: Alexander disease: white mater dystrophy of B/L frontal lobes. Adrenoleukodystrophy:white mater of B/L occipital lobes is involved. Krabbe's disease/Globoid cell leukodystrophy : involvement of B/L thalami.
Multiple sclerosis
Alexander disease
Adrenoleukodystrophy
Krabbe's disease
Radiology Q Bank