Progressive solitary sclerosis

Defining features

• There is a single demyelinating corticospinal tract lesion
• It typically presents with progressive myelopathy
• There is progression of motor impairment for >1 year
• There are no other demyelinating lesions
• There is no history of relapses in other nervous system pathways

Clinical features

Main differential diagnosis

Magnetic resonance imaging (MRI)

Cerebrospinal fluid (CSF) analysis

Treatment

References

1. Keegan BM, Kaufmann TJ, Weinshenker BG, et al. Progressive solitary sclerosis: gradual motor impairment from a single CNS demyelinating lesion. Neurology 2016; 87:1713-1719.
2. Schmalstieg WF, Keegan BM, Weinshenker BG. Solitary sclerosis: progressive myelopathy from solitary demyelinating lesion. Neurology 2012; 78:540-544. 
3. Rathnasabapathi D, Elsone L, Krishnan A, Young C, Larner A, Jacob A. Solitary sclerosis: Progressive neurological deficit from a spatially isolated demyelinating lesion: a further report. J Spinal Cord Med 2015; 38:551-555. 
4. Lattanzi S, Logullo F, Di Bella P, Silvestrini M, Provinciali L. Multiple sclerosis, solitary sclerosis or something else? Mult Scler 2014; 20:1819-1824. 

Related checklists

• Clinically isolated syndrome (CIS): clinical features
• Clinically isolated syndrome (CIS): predictors of conversion to MS
• Clinically isolated syndromes (CIS): treatment
• Radiologically isolated syndrome (RIS): predictors of conversion to MS