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A 42-Year-Old Woman With Rapidly Expanding White Matter Lesions: From the National Multiple Sclerosis Society Case
Tolulope O Amiola1, Unsong Oh1, Hope Richard1
1From the Departments of Neurology (T.O.A., U.O., M.D.G.) and Neuropathology (H.R.), VCU School of Medicine, Richmond, VA; Department of Neurology (S.D.N.), Johns Hopkins Hospital, Baltimore, MD; Department of Neurosciences (J.G.), University of California at San Diego, La Jolla and Department of Neurology (S.S.Z.), Program in Immunology, University of California at San Francisco.
A 42-year-old woman and active cocaine user complained of subacutely worsening blurred vision and imbalance. Examination of the brain MRI showed rapidly expanding white matter lesions. Brain biopsy was consistent with inflammatory demyelination. Given an unusual presentation and a history of cocaine use, a broad differential diagnosis was considered including neurologic toxidromes.
A 42-year-old woman and active cocaine user complained of subacutely worsening blurred vision and imbalance. Examination of the brain MRI showed rapidly expanding white matter lesions. Brain biopsy was consistent with inflammatory demyelination. Given an unusual presentation and a history of cocaine use, a broad differential diagnosis was considered including neurologic toxidromes.
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