At the heart of primary progressive multiple sclerosis: three cases with diffuse MRI abnormalities only

@article{Zwemmer2008AtTH,
  title={At the heart of primary progressive multiple sclerosis: three cases with diffuse MRI abnormalities only},
  author={J N P Zwemmer and Joseph C. J. Bot and Brechtje Jelles and Frederik Barkhof and Chris H. Polman},
  journal={Multiple Sclerosis},
  year={2008},
  volume={14},
  pages={428 - 430}
}
We present three patients with a clinical course and cerebrospinal fluid findings consistent with a diagnosis of primary progressive multiple sclerosis (PPMS). Extensive and repeated magnetic resonance imaging (MRI) examinations showed only diffuse abnormality in brain and spinal cord, but no focal lesions. We propose that these cases represent the most pure form of PPMS, even though according to currently applied criteria this diagnosis can not be made in the absence of focal lesions on MRI… 

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