Tumefactive multiple sclerosis (TMS): management
Evidence-based neurology checklist on tumefactive multiple sclerosis (tms): management: Magnetic resonance imaging (MRI) This shows lesions larger than 2cm The lesions are multiple lesions: this indicates demyelination rather than tumour They have high apparent diffusion coefficient (ADC) values…
Magnetic resonance imaging (MRI)
- This shows lesions larger than 2cm
- The lesions are multiple lesions: this indicates demyelination rather than tumour
- They have high apparent diffusion coefficient (ADC) values
- They demonstrate mass effect with perilesional oedema
- Isolated spinal cord involvement has been reported
Magnetic resonance imaging (MRI): enhancement patterns
Positron emission tomography (PET) scan
Autoimmune investigations
Infection screening investigations
Other blood investigations
Treatment
References
- Algahtani H, Shirah B, Alassiri A. Tumefactive demyelinating lesions: a comprehensive review. Mult Scler Relat Disord 2017; 14:72-79.
- Lucchinetti CF, Gavrilova RH, Metz I, et al. Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis. Brain 2008; 131:1759-1775.
- Hardy TA, Chataway J. Tumefactive demyelination: an approach to diagnosis and management. JNNP 2013; 84:1047-1053.
- Totaro R, Di Carmine C, Splendiani A, et al. Occurrence and long-term outcome of tumefactive demyelinating lesions in multiple sclerosis. Neurol Sci 2016; 37:1113-1117.
- Makary MS, Kirsch CF. Tumefactive demyelinating disease with isolated spinal cord involvement. Acta Radiol Short Rep 2014; 3:2047981614539324.
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