Remyelination may be noted. A thin rim of active myelin breakdown with perivenous lymphocytic cuffing is noted at the edge of the chronic active plaque. Gliosis is noted at the edge of the chronic inactive plaque. In younger patients. Usually preceded by fever and has a relentless course.
Psychiatric problems are more common.
There is confluent, asymmetric demyelination involving both cerebral and cerebellar hemispheres and brain stem. Has a concentric or lamellar pattern. Is progressive and seen in young people. Larger lesions have a tendency to coalesce and form confluent lesions. The plaques usually involve the posterior and lateral segments of the cord and they do not respect boundaries between grey and white matter and specific white matter tracts.