This 30 year old male had a week of visual blurring described as "milkiness" involving the left eye at the age of 13 years. At 24, he experienced numbness and tingling in both legs and stumbling gait. MR images show high signal in periatrial white matter on T2-weighted images, and low signal on T1 pre- and post gadolinium. These findings are typical of the non-acute plaques seen in MS. There is very little enhancement with gadolinium. The lateral ventricles are somewhat enlarged. Most of the lesion burden is in white matter, but, as seen at a higher level, grey matter is also involved.