XXXX in @entity1652 .

@entity1 @entity17 @entity1652 @entity75 @entity12280 @entity772 @entity1939 @entity854 @entity15 @entity912
BACKGROUND: @entity1652 ( @entity1652 ) is a severe @entity17 defined principally by its tendency to selectively affect optic nerves and the spinal cord causing recurrent attacks of @entity1939 and @entity912 . Contemporary diagnostic criteria require absence of clinical disease outside the optic nerve or spinal cord. We have, however, frequently encountered @entity1 with a well-established diagnosis of @entity1652 in whom either asymptomatic or symptomatic @entity75 develop suggesting that the diagnostic criteria for @entity1652 should be revised. OBJECTIVE: To describe the magnetic resonance image (MRI) brain findings in @entity1652 . DESIGN: Observational, retrospective case series. @entity1 We ascertained @entity1 through a clinical biospecimens database of individuals with definite or suspected @entity1652 . We included @entity1 who (1) satisfied the 1999 criteria of Wingerchuk et al for @entity1652 except for the absolute criterion of lacking symptoms beyond the optic nerve and spinal cord and the supportive criterion of having a normal brain MRI at onset; (2) had MRI evidence of a spinal cord lesion extending 3 vertebral segments or more (the most specific nonserological feature to differentiate @entity1652 from MS); and (3) were evaluated neurologically and by brain MRI at the Mayo Clinic. MAIN OUTCOME MEASURES: Magnetic resonance images were classified as normal or as abnormal with either nonspecific, @entity15 -like or @entity854 . We evaluated whether @entity75 were symptomatic and analyzed the neuropathologic features of a single brain biopsy specimen. RESULTS: Sixty @entity1 (53 @entity1 [88%]) fulfilled these inclusion criteria. The mean +/- SD age at onset was 37.2 +/- 18.4 years and the mean +/- SD duration of follow-up was 6.0 +/- 5.6 years. @entity1652 -IgG was detected in 41 @entity1 (68%). @entity75 were detected in 36 @entity1 (60%). Most were nonspecific, but 6 @entity1 (10%) had @entity12280 , usually asymptomatic. Another 5 @entity1 (8%), mostly @entity1 , had diencephalic, brainstem or @entity75 , atypical for @entity15 . When present, symptoms of brain involvement were subtle, except in 1 @entity1 who was @entity772 and had large @entity75 . CONCLUSIONS: Asymptomatic @entity75 are common in @entity1652 , and symptomatic @entity75 do not exclude the diagnosis of @entity1652 . These observations justify revision of diagnostic criteria for @entity1652 to allow for brain involvement.
