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Demyelinating disorders of the central nervous system may be divided into primary (cause unknown, eg, multiple sclerosis (MS)) and secondary (eg, infective, hypoxic–ischaemic, metabolic, toxic) processes. The underlying cause damages the myelin sheath and/or oligodendrocyte. MRI is the imaging modality of choice because of its high spatial and contrast resolution, but imaging features are often non-specific.
The most common causes of multifocal white matter lesions are perivascular spaces, ischaemia (small vessel disease) and MS.
Many disease processes can affect the white matter, and some may be difficult to differentiate clinically from MS. This review is intended to describe the classical and more unusual MR features of MS and how this disease may be distinguished from other processes that similarly involve the white matter.⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓⇓
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.