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Related Experiment Videos

Recurrent tumefactive demyelination in a child.

Vinod Puri1, Neera Chaudhry, Parveen Gulati

  • 1Department of Neurology, G.B.Pant Hospital, New Delhi, India. vpuri@bol.net.in

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|June 1, 2005
PubMed
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Tumefactive demyelinating lesions can mimic brain tumors on MRI scans. Early corticosteroid treatment may aid recovery in these rare neurological conditions.

Area of Science:

  • Neurology
  • Neuroimaging
  • Pathology

Background:

  • Tumefactive demyelinating lesions (TDLs) are rare, large demyelinating lesions that can mimic brain tumors on imaging.
  • Distinguishing TDLs from neoplastic or other intracranial lesions is crucial for appropriate management.

Observation:

  • A 13-year-old female experienced recurrent hemiplegia, hemianopia, and seizures.
  • Magnetic resonance (MR) imaging revealed giant, peripherally enhancing demyelinating lesions with mass effect, indistinguishable from tumors via MR spectroscopy (MRS).
  • Histopathology after tumor decompression confirmed acute demyelinating lesions, not tumors.

Findings:

  • The patient showed partial clinical recovery and radiological resolution of lesions following corticosteroid administration during both episodes.

Related Experiment Videos

  • Postoperative hemiballismus resolved after discontinuing phenytoin medication.

    • Implications:

    • Corticosteroids should be considered in the diagnostic and therapeutic approach for suspected tumefactive demyelinating lesions.
    • Despite advanced imaging, TDLs can present diagnostic challenges, necessitating a high index of suspicion and consideration of empirical treatment.