Contributions
Abstract: P275
Type: Poster
Abstract Category: Clinical aspects of MS - MS Variants
Introduction: Tumefactive multiple sclerosis is an inflammatory demyelinating disease of the central nervous system characterized by lesions measuring more than 2 cm. The disease incidence is 1 to 2 per 100 cases of multiple sclerosis; and 3 cases per million yearly in the general population.
Methods: A systematic review was done using four databases. We used the following key terms (tumefactive multiple sclerosis, tumefactive demyelinating lesions, demyelinating pseudotumor). The inclusion criteria for this review included all papers that has full patients" data. Out of 1170 articles, 87 articles met the inclusion criteria. For statistical analysis of dichotomous variables we measured the proportion and 95% confidence interval (CI). For continuous variables, we measured the mean, standard deviation (SD), and 95% CI. All data were entered and analyzed using SPSS software version 22.
Results One-hundred-six patients" data were analyzed out of 400 identified in the literature. Mean age of the patients was 33 years of age (±15). Majority of the patients were females (73%). Motor (65%), cranial nerves (33%) and sensory involvement (30%) were the commonest clinical manifestations. Oligoclonal bands came positive in 44 patients (42%). Brain biopsy was done in 51 patients (48%). Deep white matter, parietal and frontal lobes involvements were the commonest radiological manifestations. Forty-six patients (43%) were misdiagnosed initially. Steroids were implemented in the initial management in 83 patients (78%). Plasma exchange (PLEX) was used in 9 patients (10%), and IVIG in 2 patients (2%). Disease modifying therapies (DMT) were used in 15 patients (14%).
Conclusions: Tumefactive multiple sclerosis is a diagnostic challenge since it can mimic multiple conditions. Biopsy is highly recommended, especially, for those with no pre-existing multiple sclerosis, unusual presentation or non-conclusive magnetic imaging. Plasma exchange and intravenous immunoglobulin can be used as second-line in steroid resistant cases.
Disclosure: The authors have no conflict of interest to report.
Abstract: P275
Type: Poster
Abstract Category: Clinical aspects of MS - MS Variants
Introduction: Tumefactive multiple sclerosis is an inflammatory demyelinating disease of the central nervous system characterized by lesions measuring more than 2 cm. The disease incidence is 1 to 2 per 100 cases of multiple sclerosis; and 3 cases per million yearly in the general population.
Methods: A systematic review was done using four databases. We used the following key terms (tumefactive multiple sclerosis, tumefactive demyelinating lesions, demyelinating pseudotumor). The inclusion criteria for this review included all papers that has full patients" data. Out of 1170 articles, 87 articles met the inclusion criteria. For statistical analysis of dichotomous variables we measured the proportion and 95% confidence interval (CI). For continuous variables, we measured the mean, standard deviation (SD), and 95% CI. All data were entered and analyzed using SPSS software version 22.
Results One-hundred-six patients" data were analyzed out of 400 identified in the literature. Mean age of the patients was 33 years of age (±15). Majority of the patients were females (73%). Motor (65%), cranial nerves (33%) and sensory involvement (30%) were the commonest clinical manifestations. Oligoclonal bands came positive in 44 patients (42%). Brain biopsy was done in 51 patients (48%). Deep white matter, parietal and frontal lobes involvements were the commonest radiological manifestations. Forty-six patients (43%) were misdiagnosed initially. Steroids were implemented in the initial management in 83 patients (78%). Plasma exchange (PLEX) was used in 9 patients (10%), and IVIG in 2 patients (2%). Disease modifying therapies (DMT) were used in 15 patients (14%).
Conclusions: Tumefactive multiple sclerosis is a diagnostic challenge since it can mimic multiple conditions. Biopsy is highly recommended, especially, for those with no pre-existing multiple sclerosis, unusual presentation or non-conclusive magnetic imaging. Plasma exchange and intravenous immunoglobulin can be used as second-line in steroid resistant cases.
Disclosure: The authors have no conflict of interest to report.