MULTIPLE SCLEROSIS: THE LOCATION OF LESIONS WITH RESPECT TO SYMPTOMS

Abstract

Assuming that multiple sclerosis, as ordinarily understood, represents a definite disease entity having a characteristic pathologic anatomy, a correlation of signs and symptoms with lesions should be possible as in other disorders of recognized organic character. Certain difficulties, however, at once present themselves; first, owing to the relatively nondestructive character of the pathologic process, no just parallel can be drawn between its apparent extent and the resultant signs and symptoms; in the second place, exact and painstaking correlations of lesions and symptoms have rarely been attempted in the now large number of clinically observed cases with subsequent necropsy. Most writers have been content with general statements regarding pathologic findings as explanatory of symptoms, as, for example, numerous cortical areas of sclerosis, or many sclerotic patches in the pons or oblongata or the cord showing plaques in both sensory and motor tracts. The reason for this apparent inaccuracy is sufficiently obvious.