Tumefactive demyelination-A Rare Presentation of Multiple Sclerosis

Background: Multiple Sclerosis is an inflammatory demyelinating disease having varied manifestations in terms of clinical featuresand radiological features. Rarely it may present as a large lesionwith accompanying edema and mass effect, thereby simulating intracranial tumor, known Tumefactive Demyelination. Symptoms are usually related to the pressure focal lesion. When manifests patient without pre-existing MS, poses diagnostic challengeas mimic neoplasm, infarct or abscess. Thus, essential recognize this rare entity for proper management. Case Presentation: We report here case 40 years old female who presented with right sided hemiparesis. The initial brain imaging (CT) suggested left parietal lobe lesion suggestive glioma. But MRI showed cortical based parasaggital location which appeared hyperintense on both T2WI FLAIR sequences. Further evaluation by MR spectroscopy be tumefactive demyelination. She was administered IV Methylprednisolone (1gm daily 5 days) responded well treatment. characteristic magnetic resonance findings patient, its acute onset, improvement after corticosteroid therapy finally set diagnosis Conclusion: lesions pose unique challenge defining differential management should always considered young patients presenting tumour like imaging. Bangladesh Journal Medical Science Vol. 21 No. 04 October’22 Page : 931-934