Multiple sclerosis: periphlebitis retinalis et cerebro-spinalis. A correlation between periphlebitis retinalis and abnormal technetium brain scintigraphy.

Periphlebitis retinae (PR) in multiple sclerosis (MS) is seen as transitory infiltrations around veins in the otherwise normal retina. Cellular infiltrations have been found around veins in the central nervous system (CNS), where it has been suggested that they are the first event in plaque formation. Technetium brain scans are usually normal in MS patients, but transitory abnormal scans of the cerebrum have been found in MS patients during acute attack or exacerbation. In order to test the hypothesis that active PR is a sign of simultaneous disease activity in the CNS, 29 technetium brain scans were carried out on 14 MS patients with active PR and on 15 MS patients without any signs of PR. Significantly more of the patients with active PR, compared with MS patients with previous PR, displayed abnormal brain scans. This indicates that a disruption of the blood brain barrier (BBB) and active PR occur simultaneously in MS.