Tumefactive Demyelination Lesions: Report on three cases.

Area of Science:

• Neurology
• Neuroimaging
• Demyelinating Diseases

Background:

• Tumefactive demyelination (TD) and Balo's concentric sclerosis (BCS) are rare central nervous system demyelinating diseases.
• Diagnostic challenges arise due to their rarity, potentially delaying treatment.

Observation:

• Case 1: Solitary TD lesion in a male patient presenting with seizure, treated with surgery, achieving long-term remission.
• Case 2: Solitary TD lesion in a female patient with hemiparesis, treated with steroid pulse therapy, achieving long-term remission.
• Case 3: Multiple BCS and demyelinating lesions in a female patient with dysarthria and hemiparesis, treated with pulse therapy and disease-modifying therapy for multiple sclerosis.

Findings:

• TD lesions exhibit varied neuroimaging presentations, mimicking surgical conditions.
• Clinical outcomes depend on accurate diagnosis and timely therapeutic interventions.
• The study highlights the importance of distinguishing TD from neoplastic or infectious lesions.

Implications:

• Emphasizes the need for increased clinical vigilance in diagnosing rare demyelinating conditions.
• Highlights the efficacy of steroid pulse therapy and disease-modifying therapies in managing TD and BCS.
• Suggests that characteristic neuroimaging features can aid in differentiating TD from surgical pathologies.