Tumefactive multiple sclerosis presents with painless progressive hemiparesis and aphasia

MRI brain T2-weighted sequences showed a left periventricular tumefactive lesion without gadolinium (Gd) enhancement, one further periventricular lesion, three subcortical, and one in the medulla oblongata (figure). [...]having excluded progressive multifocal leukoencephalopathy from samples obtaine...

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Bibliographic Details
Published in:The Lancet (British edition) 2023-01, Vol.401 (10372), p.226-226
Main Authors: Guger, Michael, Ransmayr, Gerhard, Sonnberger, Michael, Hametner, Simon, Weis, Serge, Berger, Thomas, Enzinger, Christian
Format: Article
Language:English
Subjects:
Advisory committees
Antibodies
Aphasia
Aphasia - etiology
Biopsy
Brain - diagnostic imaging
Brain research
Encephalitis
Encephalomyelitis
Gadolinium
Humans
Lesions
Leukoencephalopathy
Magnetic Resonance Imaging
Monoclonal antibodies
Multiple sclerosis
Multiple Sclerosis - complications
Multiple Sclerosis - diagnosis
Neuropathology
Paresis
Paresis - etiology
Pharmaceutical industry
Progressive multifocal leukoencephalopathy
Viral infections
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Summary:MRI brain T2-weighted sequences showed a left periventricular tumefactive lesion without gadolinium (Gd) enhancement, one further periventricular lesion, three subcortical, and one in the medulla oblongata (figure). [...]having excluded progressive multifocal leukoencephalopathy from samples obtained at biopsy, and having obtained a negative anti-JCV antibody result, we started the patient on natalizumab as maintenance therapy for tumefactive MS. He was allowed home after 3 months. TB has participated in meetings sponsored by and received honoraria (lectures, advisory boards, and consultations) from pharmaceutical companies marketing treatments for multiple sclerosis:
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(22)02305-4