Table 3

Comparative features of multiphasic disseminated encephalomyelitis (MDEM) and relapsing-remitting MS

More likely in MDEMMore likely in relapsing-remitting MS
▸ Relapse timingUsually within 6 months of initial relapseUsually more than 6 months after initial relapse
Frequently observed shortly after cessation of corticosteroidsInfrequently associated with stopping corticosteroids
Frequently observed after further immunological challenge (infection or vaccination)Multiple relapses over many years
▸ Relapse numberIn children particularly, only one relapse is usually observedAs per table 2
▸ Relapse qualityAs per table 2Lesional dissemination in space necessary for diagnosis
Often relapse at same anatomical site giving rise to symptoms similar to initial episodeCharacteristic
▸ Secondary progressive phaseNot reportedT1 hypointensities (“black holes”)
▸ MRINormal or resolving scan during clinical remissionNew asymptomatic lesions occur during clinical remission
▸ Oligoclonal bandsAbsent or transientPresent and persistent