Solitary sclerosis is a disorder with many of the features of multiple sclerosis, but only one lesion.


The diagnosis of multiple sclerosis requires evidence for dissemination in space. This finding is lacking in a patient with solitary sclerosis where the lesion may be spatially isolated for a long time..


Clinical findings:

(1) progressive myelopathy with neurologic deficit

(2) single, spatially isolated demyelinating plaque, typically in the brainstem or upper cervical spinal cord


On MRI the lesion is/does/has:

(1) circumscribed

(2) not longitudinally extensive

(3) T2 hyperintense

(4) not occupy the entire cord or medulla

(5) no or minimal mass effect


The condition may be:

(1) misdiagnosed as a glioma or other low-grade tumor.

(2) misdiagnosed if studies to establish a diagnosis of inflammatory demyelinating disease are not performed.


Additional asymptomatic lesions may be detected if specialized or repeated imaging studies are performed.


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