A clinically silent multiple sclerosis (MS) plaque in the midcervical spinal cord was found unexpectedly at autopsy in a 66-year-old man who died of bronchogenic carcinoma. The patient's history revealed a transient episode of neurological symptoms compatible with an attack of MS more than 30 years prior to death, with no appreciable residual deficits. The discrete anatomical location of this plaque with well-preserved axons emphasizes that the retention of functional integrity of demyelinated axons may be an important factor underlying the poor clinicopathologic correlation in MS.
Ghatak NR, Hirano A, Lijtmaer H, Zimmerman HM. Asymptomatic Demyelinated Plaque. Arch Neurol. 1974;30(6):484–486. doi:10.1001/archneur.1974.00490360060012