Atypical Features of MS and NMOSD

some MS and NMOSD patients with atypical MRI findings have been identified, leading to prolonged delay to diagnosis and high costs to look for alternative diagnoses (i.e. leukodystrophy and small vessel disease). besed on the pervious knowledge if we choose the wrong drug for them their disease may aggrevate. based on review article we established a five groups classification in atypic MS: tumefactivedemyelinating lesion (TDL)-onset MS, acute disseminated encephalomyelitis (ADEM)-like MS, cavitary MS and leukodystrophy-like MS. All thepatients meeting our radiological criteria for atypical MS were included.and some atypical NMOSD patients. we collect all atypical feature of MS and NMOSD MRI features. Patients in the TDL-onset and ADEMlike groups globally presented an acute onset and a relapsing-remitting evolution. Conversely, patients in the cavitary and leukodystrophy- groups largely evolved with a progressive and severe course. SomeNMOSD patient were reported with diffuse pattern. Our goal is to ascertain some atypical MRI feature of demyelinating and astrocytopathic disease to select the best treatment in the early phase of disease. All neurologist involved in demyelinating disorder must be aware of this atypical features