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VOLUME 19 , ISSUE 6 ( 2015 ) > List of Articles

CASE REPORT

Post-operative quadriplegia as the initial manifestation of tumefactive multiple sclerosis

Behzad Maghsoudi, Hossein Haddad, Pooya Vatankhah, Alireza Rasekhi, Abbas Rahimi Jaberi

Keywords : Multiple sclerosis, postoperation, quadriplegia, tumefactive

Citation Information : Maghsoudi B, Haddad H, Vatankhah P, Rasekhi A, Jaberi AR. Post-operative quadriplegia as the initial manifestation of tumefactive multiple sclerosis. Indian J Crit Care Med 2015; 19 (6):359-361.

DOI: 10.4103/0972-5229.158281

License: CC BY-ND 3.0

Published Online: 01-06-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Post-operative quadriplegia is a rarely encountered complication and not previously reported as the initial presentation of tumefactive multiple sclerosis. We present an unusual case of a patient with such manifestation and atypical lesions on brain magnetic resonance imaging. The patient was treated with methyl prednisolone pulse therapy and showed a dramatic response. Uncommon neurologic diseases can have very unusual presentations, which should be taken into consideration when encountered with such patients. Considering this fact will help physicians in better decision-making and proper treatment planning.


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  1. Siva A. The spectrum of multiple sclerosis and treatment decisions. Clin Neurol Neurosurg 2006;108:333-8.
  2. Lucchinetti CF, Gavrilova RH, Metz I, Parisi JE, Scheithauer BW, Weigand S, et al. Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis. Brain 2008;131:1759-75.
  3. Dagher AP, Smirniotopoulos J. Tumefactive demyelinating lesions. Neuroradiology 1996;38:560-5.
  4. Poser S, Lüer W, Bruhn H, Frahm J, Brück Y, Felgenhauer K. Acute demyelinating disease. Classification and non-invasive diagnosis. Acta Neurol Scand 1992;86:579-85.
  5. Kuan YC, Wang KC, Yuan WH, Tsai CP. Tumefactive multiple sclerosis in Taiwan. PLoS One 2013;8:e69919.
  6. Kalanie H, Harandi AA, Bakhshandehpour R, Heidari D. Multiple large tumefactive MS plaques in a young man: A diagnostic enigma and therapeutic challenge. Case Rep Radiol 2012;2012:363705.
  7. Yamada S, Yamada SM, Nakaguchi H, Murakami M, Hoya K, Matsuno A, et al. Tumefactive multiple sclerosis requiring emergent biopsy and histological investigation to confirm the diagnosis: A case report. J Med Case Rep 2012;6:104.
  8. Paty DW, Oger JJ, Kastrukoff LF, Hashimoto SA, Hooge JP, Eisen AA, et al. MRI in the diagnosis of MS: A prospective study with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT. Neurology 1988;38:180-5.
  9. Barkhof F, Rocca M, Francis G, Van Waesberghe JH, Uitdehaag BM, Hommes OR, et al. Validation of diagnostic magnetic resonance imaging criteria for multiple sclerosis and response to interferon beta1a. Ann Neurol 2003;53:718-24.
  10. Iwamoto K, Oka H, Utsuki S, Ozawa T, Fujii K. Late-onset multiple sclerosis mimicking brain tumor: A case report. Brain Tumor Pathol 2004;21:83-6.
  11. Schwartz KM, Erickson BJ, Lucchinetti C. Pattern of T2 hypointensity associated with ring-enhancing brain lesions can help to differentiate pathology. Neuroradiology 2006;48:143-9.
  12. Wurm G, Parsaei B, Silye R, Fellner FA. Distinct supratentorial lesions mimicking cerebral gliomas. Acta Neurochir (Wien) 2004;146:19-26.
  13. Friedman DI. Multiple sclerosis simulating a mass lesion. J Neuroophthalmol 2000;20:147-53.
  14. Sanahuja J, Ordoñez-Palau S, Begué R, Brieva L, Boquet D. Primary Sjögren syndrome with tumefactive central nervous system involvement. AJNR Am J Neuroradiol 2008;29:1878-9.
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