Dissemination in space is demonstrated with MRI by one or more T2 lesions in at least two of four MS-typical regions of the central nervous system (periventricular, juxtacortical, infratentorial, or spinal cord) or by the development of a further clinical attack implicating a different CNS site. CSF profile no longer included.
Dissemination in time is demonstrated with MRI by the simultaneous presence of asymptomatic gadolinium-enhancing and nonenhancing lesions at any time, or a new T2 and/or gadolinium-enhancing lesion(s) on follow-up MRI, irrespective of its timing with reference to a baseline scan, or by the development of a second clinical attack.
MRI with contrast: Will see hyperintense lesions (new) and hypontense lesions (old). Old lesions on T1 imaging will appear as black holes.
Posted 01/26/17 11:13:54 AM by Adam Faye
Relapsing Remitting - Intermittent exacerbations (most convert to secondary progressive)
Primary Progressive - Progressive disability without clear exacerbations
Secondary Progressive - Progressive disability after years of relapsing/remitting
-- Primary Progressive – more rapid disease progression
-- Men progressed more quickly but outcomes not affected
-- Type of symptoms at onset did not predict disease progression
•600mg q24 weeks Ocrelizumab vs. Subq interferon beta-1a at a dose of 44ugtiw for 96 weeks •Annual Relapse Rate: 0.16 (Ocrelizumab) vs. 0.29 (Interferon) •Lower rates of disease activity and progression over a period of 96 weeks