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When the MRI scan suggests multiple sclerosis but the symptoms do not
  1. Jeremy Chataway
  1. Dr J Chataway, St Mary’s Hospital, Department of Neurology, Praed Street, London W2 1NY, UK; jeremy.chataway{at}st-marys.nhs.uk

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In the era of increasingly available MRI scanning for patients with neurological symptoms (from the worrying to the trivial), it is perhaps not unsurprising that on occasion, changes are revealed that are compatible with inflammatory demyelination, despite the lack of congruence with the clinical scenario. What does the scan mean? Also, how do you frame the discussion with the patient—particularly if s/he walks away with the scan on CD to play on their PC, which will be accompanied in a few days (weeks) time by a copy of your clinic letter. The problem is made all the worse by the fact that once the patient enters the word demyelination on …

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