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Tumefactive demyelination following in vitro fertilization (IVF)
Adi Vaknin-Dembinsky1, Yuval Bdolah2, Dimitrios Karussis1
1Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
Journal of the Neurological Sciences
|December 16, 2014
Summary
Tumefactive demyelination (TD), a rare brain lesion mimicking tumors, was observed following in-vitro fertilization (IVF). Prompt treatment with methylprednisolone led to significant clinical and radiological improvement.
Area of Science:
- Neuroimmunology
- Reproductive Medicine
Background:
- Tumefactive demyelination (TD) presents as a solitary, large demyelinating lesion in the brain, often mistaken for a tumor.
- The etiology of TD remains largely unknown, with limited understanding of its pathogenic mechanisms.
Observation:
- A 36-year-old woman developed acute right hemiparesis after undergoing in-vitro fertilization (IVF).
- Neuroimaging identified a significant left hemispheric space-occupying lesion.
Findings:
- Pathological examination confirmed the lesion as tumefactive demyelination (TD).
- Intravenous methylprednisolone treatment resulted in rapid clinical and radiological resolution of the TD lesion.
- This case represents the first documented instance of TD following IVF.
Implications:
- This case expands the known spectrum of inflammatory demyelinating conditions potentially associated with IVF.
- The findings suggest a possible role for hormonal influences related to IVF in the pathogenesis of tumefactive demyelination.
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