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January 1939


Author Affiliations

Detroit Research Professor of Neurology and Neuropathology

From the Department of Pathology, the Wayne University College of Medicine.

Arch NeurPsych. 1939;41(1):166-178. doi:10.1001/archneurpsyc.1939.02270130176011

Focal areas of demyelination, with or without degeneration of axons, are a common observation in a variety of diseases of the central nervous system and in many experimentally produced conditions. There are the circumscribed cortical lesions of dementia paralytica; the lesions described in bacillary dysentery (Spielmeyer1) and those in encephalitis following measles (Walthard,2 Ferraro and Scheffer3 and Putnam4), varicella (van Bogaert5) and variola (Brouwer6). There are the pathologic changes resulting from burns (Globus and Bender7) and carbon monoxide poisoning (doubtful case reported by Hilpert8). It is obviously a mistake to conclude that every case in which there are disseminated circumscribed areas of demyelination must be an instance of multiple sclerosis. The pathologic diagnosis depends not only on the histologic picture of the individual lesion but on its position and total distribution. In other words, if one adds to the "histotypical" characteristics what

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