Praween Lolekha MD*, Kongkiat Kulkantrakorn MD*
Affiliation : * Neurology Division, Department of Internal Medicine, Faculty of Medicine, Thammasat University
Multiple Sclerosis (MS) is a demyelinating disease of the central nervous system, characterised by focal neurological dysfunction with relapsing and remitting course. Acute widespread or tumor-like manifes- tation is one of the rare clinical variants and has poor prognosis. Here, the authors report a 36-year-old man who presented with left hemifacial and left hemibody anesthesia for one month. His symptoms gradually progressed. MRI brain showed multiple large hypersignal intensity lesions in both right and left frontopari- etal lobes, surrounding with brain edema. Brain biopsy showed perivenous infiltration of mature lymphocyte with demyelination. He was dramatically improved with high dose steroid. However, he later developed transverse myelitis syndrome. The second MRI showed new foci in both sides of splenium of corpus callosum and T9-10 spinal cord. The findings were compatible with an unusual form of multiple sclerosis that is rarely seen.
Keywords : Multiple sclerosis, Tumor-like manifestation
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