The patient presented with a sudden dysarthria, that appeared to be slighty progressive in the ensueing days. Both a vascular and demyelinating cause are possible.
The MRI-scan of the brain showed a mix of vascular and demyelinating lesions.

The MRI lesions suffice for DIS, but since the enhancing lesion was probably the symptomatic lesion, there is no proof of DIT yet.

Additional tests could be ordered to further analyze this patient. For instance, demonstration of spinal cord lesions or CSF oligoclonal bands would make MS much more likely. Further folow-up will most probably also enable us to make a more precise diagnosis.