MULTIPHASIC DISSEMINATED ENCEPHALOMYELITIS PRESENTING AS ALTERNATING HEMIPLEGIA

Two cases of alternating hemiparesis are reported, one in a black Suda nese woman, the other in a Saudi man, who had two episodes of alternat ing hemiparesis separated in time by six and three years respectively. Based on the typical appearance of the MRI and the results of brain b iopsy, the diagnosis of multiphasic disseminated encephalomyelitis was made rather than that of multiple sclerosis. This entity is also diff erentiated from recurrent disseminated encephalomyelitis, where the re lapses are symptomatically stereotyped although the appearance of the MRI is similar and in which new lesions do not occur. Because of the u nusual appearance of these MRI lesions, brain biopsy is often performe d but recognising their relevance should obviate that need.