Abstract：
BACKGROUND:Tumefactive demyelinating lesions of the central nervous system can be the initial presentation in various pathological entities [multiple sclerosis (the most common), Balo's concentric sclerosis, Schilder's disease and acute disseminated encephalomyelitis] with overlapping clinical presentation. The aim of our study was to better characterize these patients. METHODS:Eighty-seven patients (62 women and 25 men) from different MS centers in France were studied retrospectively. Inclusion criteria were (1) a first clinical event (2) MRI showing one or more large demyelinating lesions (20 mm or more in diameter) with mass-like features. Patients with a previous demyelinating event (i.e. confirmed multiple sclerosis) were excluded. RESULTS:Mean age at onset was 26 years. The most common initial symptoms (67% of the patients) were hemiparesis or hemiplegia. Aphasia, headache and cognitive disturbances (i.e. atypical symptoms for demyelinating diseases) were observed in 15, 18 and 15% of patients, respectively. The mean largest diameter of the tumefactive lesions was 26.9 mm, with gadolinium enhancement in 66 patients (81%). Twenty-one patients (24%) had a single tumefactive lesion. During follow-up (median time 5.7 years) 4 patients died, 70 patients improved or remained stable and 12 worsened. 86% of patients received initial corticosteroid treatment, and 73% received disease-modifying therapy subsequently. EDSS at the end of the follow-up was 2.4 ± 2.6 (mean ± SD). CONCLUSION:This study provides further evidence that the clinical course of MS presenting with large focal tumor-like lesions does not differ from that of classical relapsing-remitting MS, once the noisy first relapsing occurred.
journal_name
J Neuroljournal_title
Journal of neurologyauthors
Balloy G,Pelletier J,Suchet L,Lebrun C,Cohen M,Vermersch P,Zephir H,Duhin E,Gout O,Deschamps R,Le Page E,Edan G,Labauge P,Carra-Dallieres C,Rumbach L,Berger E,Lejeune P,Devos P,N'Kendjuo JB,Coustans M,Auffray-Calvdoi
10.1007/s00415-018-8984-7subject
Has Abstractpub_date
2018-10-01 00:00:00pages
2251-2259issue
10eissn
0340-5354issn
1432-1459pii
10.1007/s00415-018-8984-7journal_volume
265pub_type
杂志文章,多中心研究abstract：:The Analog Model was developed for use in patients with multiple sclerosis (MS) at an international roundtable meeting in 2001. Three key disease components are monitored, namely relapses, disability progression and magnetic resonance imaging activity. Its use provides a rapid, straightforward means of assessing the e...
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pub_type： 杂志文章,评审
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pub_type： 临床试验,杂志文章
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