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Investigators retrospectively identified seven patients seen at the Mayo Clinic during a 6-year period who had progressive myelopathy but no dissemination in time or space to confirm a clinical diagnosis of multiple sclerosis (MS). Each patient had a single brainstem or spinal cord T2 lesion on magnetic resonance imaging (MRI) and 1 year or more of progressive motor decline. Median age at onset was 43. Symptoms at onset were insidious (3 patients), subacute (1 patient), or episodic (3 patients). During a median 3 years of follow-up, six of the seven patients developed severe gait impairment; the median duration of progression before requiring a cane was 7.5 years (range, 1.5–26 years). Cerebrospinal fluid testing identified oligoclonal band…