Pearls & Oy-sters: Radiologic Lag in Pediatric-Onset Multiple Sclerosis - PubMed
5 hours ago
- #radiologic lag
- #MRI diagnostics
- #pediatric multiple sclerosis
- The case of a 16-year-old girl with bilateral internuclear ophthalmoplegias (INO) is presented, where initial high-resolution 3T MRI showed no brainstem abnormality.
- Radiologic lag, where clinical symptoms exist without corresponding MRI lesions, is crucial to recognize in suspected demyelinating diseases.
- A repeat MRI after 2 months revealed a lesion in the paramedian midbrain tegmentum, matching the anatomical location of her symptoms.
- This case highlights that radiologic lag can occur in pediatric-onset multiple sclerosis, similar to other conditions like MOG antibody-associated disease.
- Absence of visible lesions on imaging during acute INO does not rule out demyelination; short-interval follow-up imaging is recommended for diagnosis and treatment guidance.