Comparative features of multiphasic disseminated encephalomyelitis (MDEM) and relapsing-remitting MS
| More likely in MDEM | More likely in relapsing-remitting MS | |
|---|---|---|
| ▸ Relapse timing | Usually within 6 months of initial relapse | Usually more than 6 months after initial relapse |
| Frequently observed shortly after cessation of corticosteroids | Infrequently associated with stopping corticosteroids | |
| Frequently observed after further immunological challenge (infection or vaccination) | Multiple relapses over many years | |
| ▸ Relapse number | In children particularly, only one relapse is usually observed | As per table 2 |
| ▸ Relapse quality | As per table 2 | Lesional dissemination in space necessary for diagnosis |
| Often relapse at same anatomical site giving rise to symptoms similar to initial episode | Characteristic | |
| ▸ Secondary progressive phase | Not reported | T1 hypointensities (“black holes”) |
| ▸ MRI | Normal or resolving scan during clinical remission | New asymptomatic lesions occur during clinical remission |
| ▸ Oligoclonal bands | Absent or transient | Present and persistent |