Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan.
PLoS One. 2013 Jul 18;8(7):e69919. doi: 10.1371/journal.pone.0069919. Print 2013.
Multiple sclerosis (MS) is less common in Asia, including Taiwan, and some characteristics of MS in Asians differ from those of Caucasians. Tumefactive brain lesion is even rarer in MS patients.
To review patients with tumefactive MS and compare them with those in other studies investigating tumefactive demyelinating lesions and our Taiwanese typical MS patients.
Twelve patients (6.3%) from the 190 MS patients visiting Taipei Veterans General Hospital from 1985 to 2010 were enrolled. They all fulfilled the McDonald or Poser criteria for MS and had at least one brain lesion larger than 2 centimeters with or without a mass effect.
Eleven patients (91.7%) were female and presented tumefactive brain lesions during the first attack. The clinical course of all patients was relapsing-remitting with a second attack within 2 years. Their initial extended disability status score was higher, but the prognosis was better after more than 2 years of follow-up, than in other studies. Moreover, our patients did not have optic or spinal involvement as well as positive neuromyelitis optica immunoglobulin or aquaporin-4 antibody, which is very common in Taiwanese MS patients.
Tumefactive MS is not common in Taiwan. Although the tumefactive demyelinating lesions seem to be terrible initially, their prognosis is relatively more favorable than expected.
多发性硬化症（MS）在亚洲（包括中国台湾）较为少见，亚洲人的 MS 特征与白种人不同。在 MS 患者中，肿块样病变更为罕见。
回顾性分析肿块样 MS 患者，并与其他研究中的肿块样脱髓鞘病变患者及我们台湾地区典型 MS 患者进行比较。
纳入 1985 年至 2010 年间，在台北荣民总医院就诊的 190 例 MS 患者中的 12 例（6.3%）。所有患者均符合 McDonald 或 Poser 诊断标准，且至少有一处大于 2cm 的脑病变，伴或不伴有占位效应。
11 例（91.7%）为女性，在首发时即表现为肿块样脑病变。所有患者的临床病程为复发缓解型，2 年内均有二次发作。与其他研究相比，这些患者的初始扩展残疾状况评分较高，但在 2 年以上的随访后，预后更好。此外，我们的患者没有视神经或脊髓受累，以及阳性视神经脊髓炎免疫球蛋白或水通道蛋白 4 抗体，这在台湾 MS 患者中非常常见。
肿块样 MS 在台湾并不常见。虽然肿块样脱髓鞘病变在初始时看似严重，但预后比预期更为有利。
