CASE HISTORY

Patient had been a known case of disseminated sclerosis for over 25 years. Most of her signs and symptoms had been related to weakness of the lower limbs. In 1927 she was confined to bed for over a year on this account but recovered enough to get around subsequently. She never had any difficulty with vision. In 1944 she was first admitted with an advanced paraplegia involving both lower limbs. Her speech was slow but not typically scanning. There was nystagmus but no intention tumour. The reflexes were increased and there was ankle clonus and up-going plantars. She was discharged, and admitted in 1949 on account of incontinence and bedsores. She finally died of terminal respiratory infection.

PATHOLOGY

Two specimens have been mounted. The first consists of two coronal slices through the brain and both show areas of transluent rather jelly-like demyelinisation. In the upper specimen these are situated just above and lateral to the ventricles and abut on the ependyma. In the lower specimen there is a rather larger area of demyelinisation adjacent to the left lateral ventricle and two minute points of demyelination just beyond the outer border of the right. The second specimen consists of 4 weigert-pal sections mounted in a pot. The largest is taken from the edge of the lateral ventricle and shows complete lack of myelin staining in the area seen in the gross specimen. The other three are transverse sections of cord and show lack of myelin staining in irregularly scattered areas which do not correspond accurately with anatomical tracts.