Fulminant tumefactive multiple sclerosis in pregnancy

A 35-year-old pregnant woman was admitted with acute onset of paresthesias and word finding difficulty. Initial MRI scan of the brain was suggestive of ischaemic event. During hospitalisation, she had a rapid course with worsening of her neurological deficit that prompted additional testing. Further investigations were consistent with tumefactive multiple sclerosis. After a poor initial response to intravenous steroids and plasma exchange, and discussion of all available therapeutic options, the patient decided to proceed with elective termination. Introduction of physical, occupational, speech and disease-modifying therapy resulted in clinical improvement.