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https://www.readbyqxmd.com/read/28716233/-23-na-mri-reveals-persistent-sodium-accumulation-in-tumefactive-ms-lesions
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27672999/poster-238-tumefactive-demyelinating-lesions-rehabilitation-of-a-rare-debilitating-form-of-multiple-sclerosis-a-case-report
#13
Carrie M Gould, Anjum Sayyad, Grace L Maloney
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27645363/utilization-of-pet-imaging-in-differential-diagnostics-between-a-tumefactive-multiple-sclerosis-lesion-and-low-grade-glioma
#14
Aleksi Tarkkonen, Eero Rissanen, Terhi Tuokkola, Laura Airas
We present a case where a 30-year-old man with a history of combined MS and Charcot-Marie-Tooth (CMT I) disease was additionally diagnosed and treated for grade II glioma (astrocytoma). Tumefactive MS and gliomas are sometimes difficult to distinguish from one another based on conventional magnetic resonance imaging (MRI). In our case, positron emission tomography (PET) scans with(11)C-methionine ((11)C-MET) and (11)C-PK11195 radioligands were performed to aid in differential diagnostics. The diagnosis was confirmed finally by brain biopsy...
September 2016: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/27618323/white-matter-diseases-with-radiologic-pathologic-correlation
#15
Nicolae Sarbu, Robert Y Shih, Robert V Jones, Iren Horkayne-Szakaly, Laura Oleaga, James G Smirniotopoulos
White matter diseases include a wide spectrum of disorders that have in common impairment of normal myelination, either by secondary destruction of previously myelinated structures (demyelinating processes) or by primary abnormalities of myelin formation (dysmyelinating processes). The pathogenesis of many white matter diseases remains poorly understood. Demyelinating disorders are the object of this review and will be further divided into autoimmune, infectious, vascular, and toxic-metabolic processes. Autoimmune processes include multiple sclerosis and related diseases: tumefactive demyelinating lesions, Balo concentric sclerosis, Marburg and Schilder variants, neuromyelitis optica (Devic disease), acute disseminated encephalomyelitis, and acute hemorrhagic leukoencephalopathy (Hurst disease)...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27603348/a-challenging-diagnosis-of-late-onset-tumefactive-multiple-sclerosis-associated-to-cervicodorsal-syringomyelia-doubtful-ct-mri-and-bioptic-findings-case-report-and-literature-review
#16
REVIEW
Renata Conforti, Raffaella Capasso, Rosario Galasso, Mario Cirillo, Gemma Taglialatela, Luigi Galasso
BACKGROUND: Tumefactive multiple sclerosis (MS) is an unusual variant of demyelinating disease characterized by lesions with pseudotumoral appearance on radiological imaging mimicking other space-occupying lesions, such as neoplasms, infections, and infarction. Especially when the patient's medical history is incompatible with MS, the differential diagnosis between these lesions constitutes a diagnostic challenge often requiring histological investigation. An older age at onset makes distinguishing tumefactive demyelinating lesion (TDL) from tumors even more challenging...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27572815/biopsy-supported-tumefactive-demyelination-of-the-central-nervous-system-in-children
#17
Seema Bangalore Hanumanthe, Carla Francisco, Janace Hart, Jennifer Graves, Emmanuelle Waubant
Pediatric tumefactive lesions remains challenging to clinicians in terms of diagnosis and treatment. The authors describe 11 children with biopsy-proven central nervous system tumefactive demyelination. The mean age of onset was 11 years. Clinical and radiological data coupled with biopsy aided in the diagnosis of tumefactive demyelination. Of the 6 cases in which oligoclonal band data were available, only 3 showed oligoclonal band in the cerebrospinal fluid. Due to poor recovery despite treatment with high-dose glucocorticosteroids, intravenous immunoglobulin, and/or plasmapheresis, 6 cases went on to receive cyclophosphamide with marked improvement...
August 29, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27531859/is-size-an-essential-criterion-to-define-tumefactive-plaque-mr-features-and-clinical-correlation-in-multiple-sclerosis
#18
Lucia Patriarca, Silvia Torlone, Fabiana Ferrari, Caterina Di Carmine, Rocco Totaro, Ernesto di Cesare, Alessandra Splendiani
Tumefactive multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. It has recently been described as a rare subtype of multiple sclerosis (MS) characterised by the appearance of solitary or multiple space-occupying lesions associated with imaging characteristics mimicking neoplasm. Atypical features include plaque size >2 cm with mass effect, oedema, and/or ring enhancement on magnetic resonance (MR) images.This study is a retrospective review designed to evaluate the prevalence of tumefactive plaques in a selected population of 440 MS patients referred to our MS centre in Southern Italy between 2005 and 2014...
October 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27478954/atypical-inflammatory-demyelinating-syndromes-of-the-cns
#19
REVIEW
Todd A Hardy, Stephen W Reddel, Michael H Barnett, Jacqueline Palace, Claudia F Lucchinetti, Brian G Weinshenker
Atypical inflammatory demyelinating syndromes are rare disorders that differ from multiple sclerosis owing to unusual clinical or MRI findings or poor response to treatments used for multiple sclerosis. These syndromes include neuromyelitis optica spectrum disorder, acute disseminated encephalomyelitis, tumefactive demyelination, Baló's concentric sclerosis, Schilder's disease, and Marburg's multiple sclerosis. The overlapping features of these syndromes with multiple sclerosis and with each other complicate diagnosis and their categorisation as distinct or related conditions...
August 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27469383/expanding-the-range-of-immunopathology-in-neuromyelitis-optica-spectrum-disorder
#20
Jennifer Massey, Michael E Buckland, Yael Barnett, Ian Sutton
Neuromyelitis optica (NMO) spectrum disorder typically associates with a pathognomonic antibody response directed against aquaporin 4 and a unique immunopathological signature characterised by loss of aquaporin 4 expression. We describe a tumefactive presentation of NMO in which a biopsy specimen demonstrated active demyelination and reactive astrocytes with preserved surface aquaporin 4 immunoreactivity and dystrophic processes. While the astrocytic pathology is more typical of classical multiple sclerosis, a positive NMO-IgG (1:80) and subsequent clinical presentation with an area postrema syndrome is consistent with a diagnosis of NMO spectrum disorder...
July 28, 2016: BMJ Case Reports
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