Inaugural tumor-like multiple sclerosis: ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Inaugural tumor-like multiple sclerosis: clinical presentation and medium-term outcome in 87 patients
Author(s) :
Balloy, G. [Auteur]
Pelletier, Jean [Auteur]
Suchet, L. [Auteur]
Lebrun, C. [Auteur]
Cohen, M. [Auteur]
Vermersch, P. [Auteur]
ZEPHIR, Helene [Auteur]
Duhin, E. [Auteur]
Gout, O. [Auteur]
Deschamps, R. [Auteur]
Le Page, E. [Auteur]
Edan, G. [Auteur]
Labauge, P. [Auteur]
Carra-Dallieres, C. [Auteur]
Rumbach, L. [Auteur]
Berger, E. [Auteur]
Lejeune, P. [Auteur]
Devos, P. [Auteur]
N''''kendjuo, J.-B. [Auteur]
Coustans, M. [Auteur]
Auffray-Calvier, E. [Auteur]
Daumas-Duport, B. [Auteur]
Michel, L. [Auteur]
Lefrere, F. [Auteur]
Laplaud, David [Auteur]
Brosset, C. [Auteur]
Derkinderen, P. [Auteur]
De Seze, J. [Auteur]
Wiertlewski, S. [Auteur]
Pelletier, Jean [Auteur]
Suchet, L. [Auteur]
Lebrun, C. [Auteur]
Cohen, M. [Auteur]
Vermersch, P. [Auteur]
ZEPHIR, Helene [Auteur]
Duhin, E. [Auteur]
Gout, O. [Auteur]
Deschamps, R. [Auteur]
Le Page, E. [Auteur]
Edan, G. [Auteur]
Labauge, P. [Auteur]
Carra-Dallieres, C. [Auteur]
Rumbach, L. [Auteur]
Berger, E. [Auteur]
Lejeune, P. [Auteur]
Devos, P. [Auteur]
N''''kendjuo, J.-B. [Auteur]
Coustans, M. [Auteur]
Auffray-Calvier, E. [Auteur]
Daumas-Duport, B. [Auteur]
Michel, L. [Auteur]
Lefrere, F. [Auteur]
Laplaud, David [Auteur]
Brosset, C. [Auteur]
Derkinderen, P. [Auteur]
De Seze, J. [Auteur]
Wiertlewski, S. [Auteur]
Journal title :
Journal of Neurology
Abbreviated title :
J. Neurol.
Publication date :
2018-07-27
ISSN :
1432-1459
Keyword(s) :
Schilder
Demyelinating disease
Multiple sclerosis
Pseudo-tumoral form
Balo
Demyelinating disease
Multiple sclerosis
Pseudo-tumoral form
Balo
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
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 ...
Show more >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). CONCLUSIONS: 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.Show less >
Show more >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). CONCLUSIONS: 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.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Collections :
Research team(s) :
Neuroinflammation & Multiple Sclerosis (NEMESIS)
Submission date :
2021-06-23T11:45:35Z