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Table 6 Diagnostic alternatives in relation to the pattern of lesions on brain MRI (from ref. [74], modified)

From: Pediatric versus adult MS: similar or different?

Region of white matter involvement Clinical conditions Letter: It permits to identify the occurrence of the same disease in other rows
 Frontal - Alexander disease
- metachromatic leukodystrophy
- megalencephalic leukoencephalopathy with subcortical cysts
- variant adrenoleukodystrophy
a
b
 Parieto-occipital - Adrenoleukodystrophy
- Krabbe disease
- paroxisomal disorders
- mitochondrial disorders
c
d
e
 Temporal - CADASIL
- Aicardi-Goutières syndrome
- Cytomegalovirus encephalitis
- megalencephalic leukoencephalopathy with subcortical cysts
f
g
 Periventricular - Hemophagocitic lymphohisiocytosis
- metachromatic leukodystrophy
- leukoencephalopathy with brainstem-spinal cord involvement and elevated lactate
- vanishing white matter disease
- CADASIL
b
h
f
 Basal ganglia - mitochondrial disorders
- biotinidase deficiency
- Wilson disease
- Bilateral striatal necrosis
- Biotin-responsive basal ganglia disease
- Aicardi-Goutières syndrome
e
g
 Thalamus - Malignancies
- Hepatic encephalopathy
- Acute necrotizing encephalopathy
- leukoencephalopathy with thalamus and brainstem involvement and elevated lactate
- Fabry disease
i
l
m
n
 Brainstem - Malignancies
- Rhombencephalitis
- Tuberculosis
- Bechet disease
- Alexander disease
- leukoencephalopathy with thalamus and brainstem involvement and elevated lactate
- leukoencephalopathy with brainstem-spinal cord involvement and elevated lactate
i
a
m
h
Involvement of white matter tracts   
 Corticospinal - adrenoleukodystrophy
- adrenomyeloneuropathy
- Krabbe disease
- adult-onset leukoencephalopathy with axonal spheroids and pigmental glia
c
d
 Dorsal column - leukoencephalopathy with thalamus and brainstem involvement and elevated lactate
- vitamin B12/copper deficiency
m
 Subcortical U-fibers - Canavan disease
- Kearns-Sayre syndrome
 
 External capsule/insula - Acute necrotizing encephalopathy
- CADASIL
l
f
 Corpus callosum - Susac syndrome,
- Krabbe disease
d
Spinal cord   
 Hyperintensity - Sarcoidosis
- Systemic lupus erythematosus
- CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids)
- infections
 
 Atrophy - leukoencephalopathy with thalamus and brainstem involvement and elevated lactate
- Alexander disease
- adult polyglucosan body disease
m
a