TUMEFACTIVE MULTIPLE SCLEROSIS: A DIAGNOSTIC ENIGMA. A CASE REPORT

Purpose: To present a clinical case of tumefactive multiple sclerosis (TMS), which is an inflammatory demyelinating disease the central nervous system considered to be rare form (MS). It belongs group borderline forms MS – collective term used define spectrum demyelination-associated neurological conditions that share similar clinical, neuroimaging and histopathological features but vary widely in severity, course outcome. Materials/Methods: We describe 31-year-old female who was admitted Neurology clinic UMHAT “Dr Georgi Stranski” Pleven, Bulgaria, with rapid onset deficit including right-sided hemiparesis, dysarthria, imbalance, cognitive impairment urinary incontinence. MRI brain showed several tumor-like concentric lesions demyelination surrounded by moderate edema, consistent radiological criteria for disease. Results: High-dosage corticosteroids were applied intravenously this patient as acute therapy. A progressive improvement achieved after extended pulse corticosteroid therapy combination physiotherapy. Glatiramer acetate disease-modifying treatment initiated within three months had substantial efficacy. Conclusions: The diagnosis TMS always difficult requires not only complex investigations also extensive follow-up patient. believed usually has unfavorable outcome, relapsing-remitting TMS, albeit rare, possible. Our report confirms such benign variants exist. believe highlighting cases will contribute better understanding mystery MS.