Someclinical andpathologic observations on chronic myelopathy: avariant ofmultiple sclerosis

Fourpatients withprogressive demyelinatingmyelopathy withsymptoms spanningsixto25years are described. There was no clinical evidence ofdissemination oflesions inthecentral nervous system. Radiological evidenceofdissemination was presentintwo cases;inone this was absent atthetimeofpresentation andwas onlydemonstrated aftersixyears of progressive unifocal disease. Inone case, pathological examinationrevealeda solitary area ofchronic demyelination. In allcasesbutone,oligoclonal bandswere detected on cerebrospinal fluid(CSF) electrophoresis. Some cases ofchronically progressive myelopathy result from focaldemyelination intheabsenceofa secondlesiondemonstrable by clinical, radiographic or necropsy examination.