Highlights
- •Spinal cord lesions correlate with progressive disease in typical relapsing remitting MS.
- •Tumefactive demyelinating lesions occur in ∼2% of MS population.
- •Tumefactive MS (TMS) presents with signs/symptoms of a cerebral mass.
- •Progressive disease is uncommon in TMS.
- •Progression in TMS typically leads to motor impairment.
Abstract
Background
Spinal cord lesions have been associated with progressive disease in individuals with
typical relapsing remitting MS (RRMS).
Objective
In the current study, we aimed to determine if progressive disease is associated with
spinal cord lesions in those with tumefactive multiple sclerosis (MS).
Methods
Retrospective chart review of individuals presenting to Mayo Clinic with tumefactive
MS with spinal cord MRIs available (n=159). Clinical data were extracted by chart
review. Brain and spinal cord MRIs were reviewed to characterize the tumefactive demyelinating
lesion(s) and assess the burden of spinal cord disease.
Results
A total of 69 (43%) had spinal cord lesions. Progressive demyelinating disease was
documented in 13 (8%); the majority (11/13) with secondary progressive disease. The
method of progression was myelopathic in 8/13 (62%), cognitive in 3/13 (23%), motor
from a supratentorial lesion in 2/13 (16%). EDSS at last follow-up was higher in those
with progression than those without (median 6.0 (2.0-10.0) vs. 2.5 (0-10.0), p = < 0.001). Progressive demyelinating disease occurred in a minority.
Conclusions
Patients with progression typically experienced progressive motor impairment, and
this occurred exclusively in individuals with lesions in the corticospinal tracts
of the brain and/or the spinal cord.
Keywords
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Article info
Publication history
Published online: March 12, 2023
Accepted:
March 9,
2023
Received in revised form:
February 24,
2023
Received:
January 17,
2023
Identification
Copyright
© 2023 Published by Elsevier B.V.
