We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Multiple Sclerosis and Recurrent Disseminated Encephalomyelitis Are Different Diseases

Charles M. Poser, MD, FRCP
Arch Neurol. 2008;65(5):672-677. doi:10.1001/archneur.65.5.674-a.
Text Size: A A A
Published online


The recent article by de Seze et al1 correctly identifies a set of clinical signs and symptoms that may be useful in differentiating acute disseminated encephalomyelitis (DEM) from the first episode of multiple sclerosis (MS). However, their contention that DEM may evolve or convert to MS implies that the 2 conditions are, if not identical, at least closely related. In fact, they differ in at least 2 ways. Multiple sclerosis occurs in people who are genetically vulnerable, a feature noticeably lacking in DEM. Even more importantly, ever since Robert Carswell and Jean Cruveilhier published their classic illustrations of MS almost 200 years ago, the sharp edges of the typical MS lesion—so aptly described by Ludo van Bogaert as découpées à l’emporte-pièce—have been recognized by neuropathologists of the caliber of Ivan Bertrand, Jean Gruner, and François Lhermitte, to name just a few, as pathognomonic for MS; they are never seen in DEM. It is difficult to accept the concept that DEM would morph into a genetically and pathologically dissimilar disease.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

6 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles