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Markoula et al. Neuroimmunol Neuroinflammation 2017;4:188-90 Neuroimmunology and
DOI: 10.20517/2347-8659.2017.33
Neuroinflammation

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Acute demyelinating lesions with restricted

diffusion in multiple sclerosis: a new variant?

Sofia Markoula , Anastassia Zikou , Persephoni Margariti , Maria Argyropoulou , Athanassios P. Kyritsis 1
2
2
2
1
1 Department of Neurology, Medical School, University of Ioannina, 45500 Ioannina, Greece.
2 Department of Radiology, Medical School, University of Ioannina, 45500 Ioannina, Greece.
Correspondence to: Dr. Sofia Markoula, Department of Neurology, Medical School, University of Ioannina, 45500 Ioannina, Greece.
E-mail: smarkoula@grads.uoi.gr
How to cite this article: Markoula S, Zikou A, Margariti P, Argyropoulou M, Kyritsis AP. Acute demyelinating lesions with restricted diffusion in
multiple sclerosis: a new variant? Neuroimmunol Neuroinflammation 2017;4:188-90.

Article history: Received: 29 Jun 2017 Accepted: 8 Aug 2017 Published: 21 Sep 2017

Dr. Sofia Markoula is a Senior Consultant at the Department of Neurology, Ioannina University Hospital,
Greece, in charge of the Epilepsy Unit. She has been engaged in neuroimmunology, stroke, epilepsy, genetics,
neurogenetics, pharmacogenomics, experimental models of epilepsy in animals and electroencephalography
with functional magnetic resonance imaging. She has published several high-quality articles in international peer-
reviewed journals. She has been personally funded with a national grant to carry out her PhD in 2006 and has been
participating in many national and international funded projects for epilepsy, multiple sclerosis, stroke and genetics.

Typical acute demyelinating lesions in relapsing- and neurological semiology. The following pulse
remitting multiple sclerosis (RRMS) exhibit vasogenic sequences were required to have been performed
edema with increased diffusion, as demonstrated within 19 days from the onset of symptoms: T2-
by the appearance of a bright signal on apparent weighted imaging (T2WI), fluid-attenuated inversion
diffusion coefficient (ADC) maps using diffusion recovery, pre- and post-contrast T1-weighted imaging
weighted magnetic resonance imaging (MRI), while (T1WI), ADC and diffusion weighted imaging; ADLRD
[1]
acute ischemic stroke lesions demonstrate restricted were considered as present if they were demonstrated
diffusion and low signal on ADC maps. [2] on the MRI and exhibit locations corresponding to
patients’ acute symptoms and neurological semiology.
In order to identify multiple sclerosis (MS) patients with
acute demyelinating lesions with restricted diffusion Five MS patients qualified for the study (0.85%), 3
(ADLRD), a retrospective review of the medical females and 2 males, with ages ranging from 27 years
records and MRI scans of 582 patients was performed. to 42 years. Based on available medical records, 2 of
For inclusion in this study, patients must have been the patients had clinically definite RRMS, for 9 and
diagnosed with RRMS and present acute symptoms 12 years accordingly, while in the other 3 patients,

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