Bhargava Amita, Pujar Guruprasad S, Banakar Basavaraj F, Shubhkaran K, Hemant Jangid
Department of Neurology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Department of Radiodiagnosis, Satyam MRI Centre, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
J Pediatr Neurosci. 2015 Jan-Mar;10(1):55-7. doi: 10.4103/1817-1745.154346.
Tumefactive multiple sclerosis (MS) is a rare variant of MS characterized by the presence of large demyelinating plaques of more than 2 cm, identified with magnetic resonance imaging (MRI). Distinguishing tumefactive lesions from other etiologies of intracranial space occupying lesions is necessary to avoid the inadvertent intervention. We had a 14-year-old girl who presented to us with two episodes of subacute hemiparesis over a span of 6 months. Her MRI brain showed large lesions, which were hyperintense on T2-weighted/flair images with incomplete ring enhancement open towards the gray matter in postgadolinium images with minimal surrounding edema and mass effect. We treated her as a case of tumefactive demyelination (TD) with steroids after which patient recovered with minimal deficits. TD occurs more commonly in women and young adults and is reported rarely. TD in a young girl with recurrence in such short span causing bilateral hemiparesis has never been reported.
瘤样脱髓鞘性多发性硬化（MS）是MS的一种罕见变异型，其特征是存在通过磁共振成像（MRI）识别出的直径超过2 cm的大的脱髓鞘斑块。将瘤样病变与颅内占位性病变的其他病因区分开来对于避免不必要的干预很有必要。我们有一名14岁女孩，在6个月内出现了两次亚急性偏瘫发作。她的脑部MRI显示有大的病变，在T2加权/液体衰减反转恢复（FLAIR）图像上呈高信号，在钆增强后的图像中呈不完全环形强化，向灰质开放，周围水肿和占位效应最小。我们将她作为瘤样脱髓鞘（TD）病例用类固醇进行治疗，之后患者恢复，遗留最小程度的功能缺损。TD在女性和年轻人中更常见，且报道较少。从未有过关于一名年轻女孩在如此短的时间内复发并导致双侧偏瘫的TD的报道。
