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https://www.readbyqxmd.com/read/29331745/tumefactive-multiple-sclerosis-masquerading-as-high-grade-glioma
#1
Michelle Lin, Patrick Reid, Joshua Bakhsheshian
Tumefactive multiple sclerosis is a demyelinating lesion that can radiographically mimic high-grade gliomas during acute episodes, thus affecting clinical decision making. A delay in appropriate diagnoses can result in unnecessary invasive resections. The following case is a patient with unilateral weakness and radiologic findings that were concerning for a high-grade glioma. Peripheral studies were equivocal. The decision was made to proceed with a stereotactic biopsy, yielding a definitive diagnosis of tumefactive demyelinating lesion (TDL)...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29290197/primary-cns-lymphoma-vs-tumefactive-multiple-sclerosis-a-diagnostic-challenge
#2
Sameen Bin Naeem, Farheen Niazi, Atif Baig, Hina Sadiq, Mubbasher Sattar
Primary CNS (central nervous system) lymphoma is a rare condition with the incidence of less than 1% of all non-Hodgkin lymphomas (NHLs) and approximately 2% of all primary brain tumours. Diagnosis can be challenging and necessitates brain biopsy for definitive diagnosis. A 41-year male presented with history of impaired cognition, facial asymmetry, visual impairment and left sided body weakness. MRI brain demonstrated multiple enhancing lesions with one larger lesion in right basal ganglia with surrounding oedema and mass effect...
January 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29141790/cerebral-toxoplasmosis-in-an-ms-patient-receiving-fingolimod
#3
Alejandro Enriquez-Marulanda, Jaime Valderrama-Chaparro, Laura Parrado, Juan Diego Vélez, Ana Maria Granados, Jorge Luis Orozco, Jairo Quiñones
Multiple Sclerosis (MS) is an autoimmune disease in which lymphocytes target putative myelin antigens in the CNS, causing inflammation and neurodegeneration. Fingolimod (FTY720) is an immunosuppressive drug used as a second line therapy for relapsing forms of MS due to its safety profile and good response to treatment. Despite its safety, there are still concerns about the possibility of Fingolimod being linked to the development of opportunistic infections like disseminated varicella zoster infections and herpes simplex encephalitis...
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29064441/pattern-recognition-of-the-multiple-sclerosis-syndrome
#4
REVIEW
Rana K Zabad, Renee Stewart, Kathleen M Healey
During recent decades, the autoimmune disease neuromyelitis optica spectrum disorder (NMOSD), once broadly classified under the umbrella of multiple sclerosis (MS), has been extended to include autoimmune inflammatory conditions of the central nervous system (CNS), which are now diagnosable with serum serological tests. These antibody-mediated inflammatory diseases of the CNS share a clinical presentation to MS. A number of practical learning points emerge in this review, which is geared toward the pattern recognition of optic neuritis, transverse myelitis, brainstem/cerebellar and hemispheric tumefactive demyelinating lesion (TDL)-associated MS, aquaporin-4-antibody and myelin oligodendrocyte glycoprotein (MOG)-antibody NMOSD, overlap syndrome, and some yet-to-be-defined/classified demyelinating disease, all unspecifically labeled under MS syndrome ...
October 24, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28991707/tumefactive-demyelinating-lesions-of-15-patients-clinico-radiological-features-management-and-review-of-the-literature
#5
Pedro Sánchez, Virginia Meca-Lallana, Antonio Barbosa, Rafael Manzanares, Itziar Palmí, José Vivancos
BACKGROUND AND OBJECTIVE: Tumefactive demyelinating lesions (TDLs) are large inflammatory lesions that can mimic tumors or other space-occupying lesions. Differential diagnosis and management of these lesions remain challenging for neurologists. We aim to review the clinico-radiological features of patients with TDLs, as well as their management. METHODS: We performed a retrospective review of cases of TDLs treated in our center from January 2010 to February 2017...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28932291/neurological-safety-of-fingolimod-an-updated-review
#6
REVIEW
Fumihito Yoshii, Yusuke Moriya, Tomohide Ohnuki, Masafuchi Ryo, Wakoh Takahashi
Fingolimod (FTY) is the first oral medication approved for treatment of relapsing-remitting multiple sclerosis (RRMS). Its effectiveness and safety were confirmed in several phase III clinical trials, but proper evaluation of safety in the real patient population requires long-term post-marketing monitoring. Since the approval of FTY for RRMS in Japan in 2011, it has been administered to approximately 5000 MS patients, and there have been side-effect reports from 1750 patients. Major events included infectious diseases, hepatobiliary disorders, nervous system disorders and cardiac disorders...
August 2017: Clinical & Experimental Neuroimmunology
https://www.readbyqxmd.com/read/28912286/association-of-developmental-venous-anomalies-with-demyelinating-lesions-in-patients-with-multiple-sclerosis
#7
D M Rogers, M E Peckham, L M Shah, R H Wiggins
We present 5 cases of demyelination in patients diagnosed with multiple sclerosis that are closely associated with a developmental venous anomaly. Although the presence of a central vein is a known phenomenon with multiple sclerosis plaques, demyelination occurring around developmental venous anomalies is an underreported phenomenon. Tumefactive demyelination can cause a diagnostic dilemma because of its overlapping imaging findings with central nervous system neoplasm. The relationship of a tumefactive plaque with a central vein can be diagnostically useful, and we suggest that if such a lesion is closely associated with a developmental venous anomaly, an inflammatory or demyelinating etiology should be a leading consideration...
January 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28900612/coexistence-of-multiple-sclerosis-and-brain-tumor-an-uncommon-diagnostic-challenge
#8
Fatemeh Abrishamchi, Fariborz Khorvash
Nonneoplastic demyelinating processes of the brain with mass effect on magnetic resonance imaging can cause diagnostic difficulties. It requires differential diagnosis between the tumefactive demyelinating lesion and the coexistence of neoplasm. We document the case of 41-year-old woman with clinical and radiological findings suggestive of multiple sclerosis. Additional investigations confirmed the coexistence of astrocytoma. This report emphasizes the importance of considering brain tumors in the differential diagnosis of primary demyelinating disease presenting with a cerebral mass lesion...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28716233/-23-na-mri-reveals-persistent-sodium-accumulation-in-tumefactive-ms-lesions
#9
Konstantin Huhn, Angelika Mennecke, Peter Linz, Franz Tschunko, Nicola Kästle, Armin M Nagel, Michael Uder, Arnd Dörfler, Ralf A Linker, Tobias Engelhorn
BACKGROUND: Chronic inflammatory demyelinating diseases of the CNS typically show a limited lesion size. However, extended lesions may appear with an atypical configuration. Large lesions with a diameter>2cm accompanied by tumor-like edema are entitled "tumefactive" and may occur in multiple sclerosis (MS) and other demyelinating diseases. Historically, differential diagnosis often requires histological analysis. Therefore, advanced imaging techniques are warranted to allow for a precise non-invasive diagnosis...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28698732/tumefactive-multiple-sclerosis-variants-report-of-two-cases-of-schilder-and-balo-diseases
#10
Mahmoud Reza Ashrafi, Ali Reza Tavasoli, Houman Alizadeh, Javad Zare Noghabi, Nima Parvaneh
A tumefactive lesion of central nervous system (CNS) is defined as a mass-like lesion with a size greater than 2 cm in brain detected by magnetic resonance imaging (MRI). Neuroimaging may help to distinguish the nature of a tumefactive lesion and therefore, can prevent an unnecessary brain biopsy. Here we emphasized on determining the nature of a CNS tumefactive lesions with the help of MRI and more explanations about demyelinating lesions with focus on Schilder and Balo diseases as two multiple sclerosis variants...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/28657431/csf-and-clinical-data-are-useful-in-differentiating-cns-inflammatory-demyelinating-disease-from-cns-lymphoma
#11
Ryotaro Ikeguchi, Yuko Shimizu, Satoru Shimizu, Kazuo Kitagawa
BACKGROUND: It is often difficult to diagnose central nervous system (CNS) inflammatory demyelinating diseases (IDDs) because they are similar to CNS lymphoma and glioma. OBJECTIVE: To evaluate whether cerebrospinal fluid (CSF) analysis can differentiate CNS IDDs from CNS lymphoma and glioma. METHODS: We measured CSF cell counts; concentrations of proteins, glucose, interleukin (IL)-6, IL-10, soluble IL-2 receptor (sIL-2R), and myelin basic protein; and IgG index in patients with multiple sclerosis (MS, n = 64), neuromyelitis optica spectrum disorder (NMOSD, n = 35), tumefactive demyelinating lesion (TDL, n = 17), CNS lymphoma ( n = 12), or glioma ( n = 10)...
June 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28619436/tumefactive-demyelinating-lesions-a-comprehensive-review
#12
REVIEW
Hussein Algahtani, Bader Shirah, Ali Alassiri
Tumefactive multiple sclerosis or tumefactive demyelinating lesion (TDL) is one of the rare variants of multiple sclerosis (MS) posing a diagnostic challenge and a therapeutic enigma since it is difficult to distinguish from a true central nervous system (CNS) neoplasm or other CNS lesions on magnetic resonance imaging (MRI). The prevalence of TDL is estimated to be 1-3/1000 cases of MS with an annual incidence of 0.3/100,000. This could be an underestimate due to unavailability of a global MS registry and under-reporting of this condition...
May 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28611164/fulminant-tumefactive-multiple-sclerosis-in-pregnancy
#13
Shabnam Pakneshan, Evanthia Bernitsas
A 35-year-old pregnant woman was admitted with acute onset of paresthesias and word finding difficulty. Initial MRI scan of the brain was suggestive of ischaemic event. During hospitalisation, she had a rapid course with worsening of her neurological deficit that prompted additional testing. Further investigations were consistent with tumefactive multiple sclerosis. After a poor initial response to intravenous steroids and plasma exchange, and discussion of all available therapeutic options, the patient decided to proceed with elective termination...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28528469/multiple-sclerosis-treatment-with-fingolimod-profile-of-non-cardiologic-adverse-events
#14
REVIEW
Yara Dadalti Fragoso
Fingolimod was the first oral medication approved for management of multiple sclerosis and is currently used by tens of thousands patients worldwide. Fingolimod acts via the sphingosine 1-phosphate (S1P) receptor, maintaining peripheral lymphocytes entrapped in the lymph nodes. In consequence, there is a reduction in the infiltration of aggressive lymphocytes into the central nervous system. The drug is safe and effective, and its first hours of use are associated with related to S1P receptors in the heart...
May 20, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28488621/tumefactive-acute-disseminated-encephalomyelitis
#15
Sunil Pradhan, Surjyaprakash S Choudhury, Animesh Das
Tumefactive demyelinating lesions are tumour-like presentations of acute demyelinating lesions. They have been described with multiple sclerosis only and not with other varieties of acquired demyelination like acute disseminated encephalomyelitis (ADEM). The uncertainty about the diagnosis at the onset of the disease in tumefactive ADEM makes it important that the physicians should be aware of this entity. Various radiological similarities with more sinister lesions like central nervous system gliomas or lymphomas may lead to this confusion...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28203460/the-prevalence-of-anti-aquaporin-4-antibody-in-patients-with-idiopathic-inflammatory-demyelinating-diseases-presented-to-a-tertiary-hospital-in-malaysia-presentation-and-prognosis
#16
S Abdullah, W F Wong, C T Tan
Background. There have been inconsistent reports on the prevalence and pathogenicity of anti-Aquaporin 4 (AQP4) in patients presented with idiopathic inflammatory demyelinating diseases (IIDDs). Objective. To estimate the prevalence of anti-AQP4 antibody in patients with IIDDs presented to University Malaya Medical Centre in terms of patients' clinical and radiological presentations and prognoses. Methods. Retrospective data review of IIDDs patients presented from 2005 to 2015. Patients were classified into classical multiple sclerosis (CMS), opticospinal (OS) presentation, optic neuritis (ON), transverse myelitis (TM), brainstem syndrome (BS), and tumefactive MS...
2017: Multiple Sclerosis International
https://www.readbyqxmd.com/read/28179462/tumefactive-demyelination-following-treatment-for-relapsing-multiple-sclerosis-with-alemtuzumab
#17
Joshua Barton, Todd A Hardy, Sean Riminton, Stephen W Reddel, Yael Barnett, Alasdair Coles, Michael H Barnett
No abstract text is available yet for this article.
March 7, 2017: Neurology
https://www.readbyqxmd.com/read/28132974/a-case-of-pediatric-multiple-sclerosis-presenting-with-a-tumefactive-demyelinating-lesion
#18
REVIEW
Hisakazu Majima, Tsuyoshi Ito, Norihisa Koyama
Pediatric multiple sclerosis accompanied by a tumefactive demyelinating lesion (TDL) is extremely rare. Because it is very difficult to distinguish TDLs from neoplasms, invasive brain biopsies are required for a definitive diagnosis. MR spectroscopy (MRS) without brain biopsy was recently shown diagnostic in some patients with TDLs, based on the elevation of glutamate/glutamine peaks. This report describes the clinical course of a 9-year-old girl with multiple sclerosis following a TDL and discusses the usefulness of MRS and brain biopsies to diagnose TDLs...
February 25, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28090055/natalizumab-is-effective-for-the-treatment-of-relapsing-remitting-tumefactive-multiple-sclerosis
#19
Masataka Nakamura, Kumi Itani, Kousuke Miyake, Takenobu Kunieda, Satoshi Kaneko, Hirofumi Kusaka
We herein report the case of a 57-year-old woman presenting with a biopsy-proven tumefactive demyelinating lesion as her first clinical event. Subsequently, she displayed a relapsing-remitting course with recurrence of large demyelinating lesions exceeding 2 cm in diameter rather than the small ovoid lesions characteristic of multiple sclerosis. Administration of interferon beta did not suppress the disease activity. Finally, treatment with natalizumab, which is a humanized monoclonal antibody against the cell-adhesion molecule α4-integrin, was initiated, resulting in clinical and radiological stabilization...
2017: Internal Medicine
https://www.readbyqxmd.com/read/27721782/role-of-therapeutic-plasma-exchange-in-treatment-of-tumefactive-multiple-sclerosis-associated-low-cd4-and-cd8-levels
#20
Kristen Lew, Nishith Mewada, Sahana Ramanujam, Bahareh Hassanzadeh, John E Donahue, Leema Reddy Peddareddygari, Robert Moser, Charles Kososky, Raji P Grewal
We report a 35-year-old healthy male who developed central nervous system inflammatory demyelinating disease consistent with tumefactive multiple sclerosis. About 2 weeks after onset of symptoms and prior to initiation of therapy, the patient had lymphopenia and low CD4 and CD8 levels. His lymphocyte count was 400 cells/µl (850-3,900 cells/µl), CD4 was 193 cells/µl (490-1,740 cells/µl) and CD8 was 103 cells/µl (180-1,170 cells/µl). He was treated with intravenous methylprednisolone followed by therapeutic plasma exchange, the levels of CD4 and CD8 normalized, and ultimately, he recovered completely...
May 2016: Case Reports in Neurology
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