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Figure 1: MRI Brain showed large (>2 cm) lesions in the sub-cortical regions involving bilateral frontoparietal lobes. Central hyperintense rounded area (black arrows) was noted on T2W (a), which was hypointense on T1W (b), and showed significant suppression on FLAIR (c). Post gadolinium, incomplete “arc-like” peripheral enhancement on the medial side towards the ventricles and centrum-semiovale (white arrows) (d) was present. There was no enhancement with ADC values on DWI (e) and MR spectroscopy (f) suggestive of central myelinoclastic activity, pointing to Schilder's variant of multiple sclerosis

Figure 1: MRI Brain showed large (>2 cm) lesions in the sub-cortical regions involving bilateral frontoparietal lobes. Central hyperintense rounded area (black arrows) was noted on T2W (a), which was hypointense on T1W (b), and showed significant suppression on FLAIR (c). Post gadolinium, incomplete “arc-like” peripheral enhancement on the medial side towards the ventricles and centrum-semiovale (white arrows) (d) was present. There was no enhancement with ADC values on DWI (e) and MR spectroscopy (f) suggestive of central myelinoclastic activity, pointing to Schilder's variant of multiple sclerosis