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Tumefactive multiple sclerosis is a condition in which the central nervous system of a person has multiple demyelinating lesions with atypical characteristics for those of standard multiple sclerosis (MS). It is called tumefactive as the lesions are "tumor-like" and they mimic tumors clinically, radiologically and sometimes pathologically.
Demyelinating diseases of the CNS can be classified according to their pathogenesis into five non-exclusing categories: demyelination due to inflammatory processes, viral demyelination, demyelination caused by acquired metabolic derangements, hypoxic–ischaemic forms of demyelination and demyelination caused by focal compression. [3]
Historically, acute MS was a fatal disease, with death occurring within a year of onset, often secondary to extensive brainstem demyelination. Treatments include plasma exchange and/or high-dose glucocorticoids (e.g., 1 g/day of methylprednisolone for 3–5 days).
diagnosis via lab test, imaging and symptoms Current standards for diagnosing multiple sclerosis (MS) are based on the 2018 revision of McDonald criteria . They rely on MRI detection (or clinical demonstration) of demyelinating lesions in the CNS, which are distributed in space (DIS) and in time (DIT).
Inflammatory demyelinating diseases (IDDs), sometimes called Idiopathic (IIDDs) due to the unknown etiology of some of them, are a heterogenous group of demyelinating diseases - conditions that cause damage to myelin, the protective sheath of nerve fibers - that occur against the background of an acute or chronic inflammatory process.
The McDonald criteria maintained a scheme for diagnosing MS based solely on clinical grounds but also proposed for the first time that when clinical evidence is lacking, magnetic resonance imaging (MRI) findings can serve as surrogates for dissemination in space (DIS) and/or time (DIT) to diagnose MS. [5] The criteria try to prove the existence ...
Whatever the demyelination process is, currently it is possible to detect lesions before demyelination, and they show clusters of activated microglia and leukocyte infiltration, together with oligodendrocytes abnormalities. [100] Some research groups consider some areas of the NAWM with clusters of microglial nodules as "preactive MS lesions".
As a demyelinating disease, MS disrupts the nervous system's ability to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. [ 1 ] [ 8 ] [ 9 ] Symptoms include double vision , vision loss, eye pain, muscle weakness, and loss of sensation or coordination.