Recurrent encephalopathy associated with pegylated beta-interferon treatment

Area of Science:

• Neuroimmunology
• Pharmacology

Background:

• Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• Interferon-beta therapies are commonly used to manage MS.
• Adverse neurological events can occur with interferon treatment.

Observation:

• A 62-year-old woman with MS developed transient episodes of confusion, dysarthria, and gait disturbance.
• These neurological symptoms consistently appeared approximately 3 days after receiving pegylated interferon-beta-1a.
• Symptoms spontaneously resolved within 4 days, with no other cause identified via MRI or CSF analysis.

Findings:

• The patient's recurrent encephalopathic syndrome was strongly suspected to be linked to pegylated interferon-beta-1a.
• Discontinuation of interferon and initiation of teriflunomide led to complete symptom resolution.
• Potential mechanisms include interferon's impact on inflammatory cytokines and endothelial function.

Implications:

• This case highlights a potential adverse effect of pegylated interferon-beta-1a, specifically recurrent encephalopathy.
• Clinicians should consider interferon-induced neurotoxicity in MS patients presenting with unexplained neurological episodes.
• Further investigation into the neuroinflammatory and vascular effects of interferon is warranted.