An autopsy case of Schilder's variant of multiple sclerosis (Schilder's disease).

tional cases under the same eponym, but the case reported in 1913 was later identifi ed to be adrenoleukodystrophy, and the 1924 case subacute sclerosing panencephalitis. The diagnostic criteria of ‘true’ Schilder’s disease have been proposed in 1986 [1] . There should be large (at least 3 ! 2 cm) bilateral plaques in the centrum semiovale of the cerebral hemispheres with histological characteristics identical to MS. Here, we report the fi rst case of elderly onset Schilder’s disease confi rmed by auDear Sir, Schilder’s disease or myelinoclastic diffuse sclerosis is a rare form of primary demyelinating disease, which is now considered to be a variant of multiple sclerosis (MS) [1, 2] . In 1912, Schilder described a case of a 14-year-old girl who had signs of mental deterioration associated with an increased intracranial pressure. She died after 19 weeks of her illness, and autopsy revealed large areas of sharply demarcated plaques of demyelination in both hemispheres [3] . Subsequently, Schilder reported two addiReceived: June 13, 2005 Accepted: January 10, 2006 Published online: April 21, 2006