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A Report of Two Cases

Jan Lodder, MD, PhD; Aldo W. de Weerd, MD, PhD; Johan C. Koetsier, MD, PhD; Paul J. M. van der Lugt, MD, PhD

Arch Neurol. 1983;40(5):320-322.

Abstract
• In two cases of acute cerebral multiple sclerosis, computed tomographic (CT) scans with contrast disclosed several enhanced foci, mainly situated in the periventricular white matter and, in one patient, in the cerebellum. Administration of dexamethasone sodium phosphate in one patient and prednisone with cyclophosphamide in the other was followed by considerable clinical improvement. Successive CT scans with contrast enhancement showed a close correlation between improvement of symptoms and the subsidence of contrast-enhanced foci during treatment. Perhaps clinical improvement reflected restoration of the impaired blood-brain barrier.

Author Affiliations
From the Department of Neurology, St Annadal Hospital, Medical Faculty of the Rijksuniversiteit Limburg, Maastricht, the Netherlands (Dr Lodder and Dr van der Lugt), the TNO Research Unit of Neurophysiology, Westeinde Hospital, The Hague (Dr de Weerd), and the Department of Neurology, Vrije Universiteit, Amsterdam (Dr Koetsier).

Footnotes
Accepted for publication June 30, 1982.

Reprint requests to Department of Neurology, St Annadal Hospital, Medical Faculty of the Rijksuniversiteit Limburg, PO Box 1918, 6201 BX Maastricht, the Netherlands (Dr Lodder).

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