MIR in atypical idiopathic inflammatory demyelinating disease treated with methylprednisolone and cyclophosphamide.

and moderate ataxia. The cerebrospinal fluid (CSF) analysis revealed a mild pleocytosis (17/3 mononuclear cells), a dysfunction of the blood brain barrier and oligoclonal bands without corresponding findings in the serum. The MRI on the day of admission showed large, partly confluent lesions with perifocal edema, T1-hypo-intensity as a correlate of severe tissue damage as well as concentric gadolinium enhancing lesions The differential diagnosis of multi-focal enhancing lesions in cranial magnetic resonance imaging (MRI) is often difficult and includes a wide spectrum of differential diagnoses including atypical idiopathic inflammatory demyelinating lesions.[1,2] We report an 18-year-old woman who developed severe multi-focal neurological symptoms within few weeks presenting with somnolence, dysarthria, asymmetric tetraparesis