Silent Tumefactive Demyelinating Lesions and Radiologically Isolated Syndrome

Table 1

Proposed diagnostic criteria for radiologically isolated syndrome [8].

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(A) The presence of incidentally identified CNS white matter anomalies meeting the following MRI criteria

 (1) Ovoid, well-circumscribed and homogeneous foci with or without involvement of the corpus callosum

 (2) T2 hyperintensities measuring >3 mm and fulfilling Barkhof criteria (at least three out of four) for dissemination in space

   [(i) the presence of at least one gadolinium enhancing lesion or nine T2 hyperintense lesions; (ii) the presence of at least one infratentorial lesion; (iii) the presence of at least one juxtacortical lesion; and (iv) the presence of at least three periventricular lesions]

 (3) CNS white matter anomalies not consistent with a vascular pattern

(B) No historical accounts of remitting clinical symptoms consistent with neurological dysfunction

(C) The MRI anomalies do not account for clinically apparent impairments in social, occupational or generalized areas of functioning

(D) The MRI anomalies are not due to the direct physiological effects of substances (recreational drug abuse, toxic exposure) or a medical condition

(E) Exclusion of individuals with MRI phenotypes suggestive of leukoaraiosis or extensive white matter pathology lacking involvement of the corpus callosum

(F) The CNS MRI anomalies are not better accounted for by another disease process

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