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Definition
 
frFrench
escarpin definition: Soulier découvert et à mince semelle.
 
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In a subtype of lesions, which are mainly found in patients with acute fulminant multiple sclerosis with Balo's type concentric sclerosis and in a subset of early relapsing remitting multiple sclerosis, the initial myelin changes closely resemble those seen in white matter stroke (WMS), suggesting a hypoxia-like tissue injury.

Don Mahad et al.

Brain 131 (7), 01 Jul 2008

2000 ), which are mainly found in patients with acute fulminant multiple sclerosis with Balo's type concentric sclerosis and in a subset of early relapsing remitting multiple sclerosis, has been defined by the selective early loss of myelin associated glycoprotein (MAG) and cyclic nucleotide phosphodiesterase (CNPase) together with apoptotic cell death of oligodendrocytes (Itoyama et al ., 1980 ; Lucchinetti et al ., 2000 ; Barnett and Prineas, 2004 ; Stadelmann et al ., 2005 ).

Don Mahad et al.

Brain 131 (7), 01 Jul 2008

Lesion classification The Pattern III lesions in the early active (EA) stage ( n = 12), including Balo's type, were identified based on the preferential loss of MAG or CNPase and the absence of immunoglobulins and complement deposition, as previously described (Lucchinetti et al ., 2000 ).

Don Mahad et al.

Brain 131 (7), 01 Jul 2008

Pattern III multiple sclerosis lesions. (a–d) The brain sections containing Pattern III and Balo's type (with concentric rings of preserved myelin) active multiple sclerosis lesions are stained for LFB (a), HLA (b), MAG (c)and PLP (d).

Don Mahad et al.

Brain 131 (7), 01 Jul 2008

Interestingly, COX-I immunoreactivity is preserved in the concentric rings of the Balo's type multiple sclerosis lesion (e). g–i: Higher magnification images show the punctate COX-I (g), porin (h) and COX-IV (i) immunoreactive elements, typical of mitochondrial staining, in the NWM (left column), EA stage (middle column) and LA stage (right column).

Don Mahad et al.

Brain 131 (7), 01 Jul 2008