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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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Systemic Lymphoma Masquerading as Multiple Sclerosis Relapse.

Lisle W Blackbourn1, Tiffani S Franada1, Sarah E Bach2

  • 1Neurology, University of Illinois College of Medicine Peoria, Peoria, USA.

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|December 11, 2023
PubMed
Summary
This summary is machine-generated.

Diagnosing multiple sclerosis (MS) can be challenging due to its varied symptoms and potential mimics. This case highlights the importance of considering differential diagnoses even in patients with a known history of MS.

Keywords:
enhancing brain lesionsfingolimodlymphomamultiple sclerosismultiple sclerosis flare-ups

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Area of Science:

  • Neurology
  • Immunology
  • Neuroimmunology

Background:

  • Multiple Sclerosis (MS) is a chronic, immune-mediated central nervous system disease.
  • MS symptoms vary widely depending on lesion location in the brain and spinal cord.
  • Differentiating MS from other conditions with similar presentations is often difficult.

Observation:

  • A 69-year-old female with a history of relapsing-remitting MS presented with an eight-week progressive neurological decline.
  • Clinical manifestations included internuclear ophthalmoplegia, bilateral ataxia, and hemiparesis.
  • The patient had a history of melanoma, status post-excision.

Findings:

  • The patient's presentation mimicked new MS activity but required careful consideration of differential diagnoses.
  • Conditions mimicking MS include inflammatory, neoplastic, infectious, metabolic, and genetic disorders.
  • Diagnostic challenges are amplified in patients with an established MS diagnosis.

Implications:

  • A broad differential diagnosis is crucial when evaluating patients with suspected MS, even with a prior diagnosis.
  • Consideration of biopsy for new lesions unresponsive to immunotherapy may be warranted.
  • Accurate diagnosis is essential for appropriate patient management and treatment strategies in complex neurological cases.