Fulminant form of multiple sclerosis simulating brain tumor: A case with parkinsonian features and pathologic study

Abstract

SUMMARY -We describe the case of a 48 year-old man in whom the clinical features, CT and MR scans were suggestive of a brain tumor but, posteriorly, another MRI study, CSF examination and brain biopsy supported the diagnosis of multiple sclerosis. Interestingly, this patient presented parkinsonian features, probably in connection with the underlying disease.KEY WORDS: multiple sclerosis, tumoral form, parkinsonism. The authors report the case of a patient with the tumoral form of MS and parkinsonian features. To the best of our knowlegde, this association has hardly been reported in the current literature.

A unique case of coincidence of early onset Parkinson's disease and multiple sclerosis

“…An unequivocally causal relationship was evident in six cases 1–5. The supporting evidence was as follows: rapid onset in all cases, strategically located demyelinating lesion in five cases,1–4 and/or almost complete resolution of extrapyramidal signs after corticosteroids 1, 3, 5.…”

“…To date 15 cases of parkinsonism1–11 in MS patients have been reported. The relationship between MS and parkinsonism has been argued, more or less convincingly, to be either causal or coincidental.…”

Multiple sclerosis exceptionally presenting as parkinsonism responds to intravenous methylprednisolone

“…The onset of parkinsonism was rapid in these patients and they exhibited strategically located lesions on MRI and/or significant improvement of extra pyramidal features with immune-suppression. [3][4][5][6][7][8][9] Anti-parkinsonian medication was tested in three patients, with improvement observed in one. 3 The parkinsonian features in our patient are considered to be an expression of MS. From onset, parkinsonism responded poorly to anti-parkinsonian medication.…”

Unexpected aggravation of Parkinson?s disease by a mesencephalic multiple sclerosis lesion

“…Sirs: The association of multiple sclerosis (MS) with Parkinsonism is rare [2, 4,5,7,9,11,13,14]. Two hypotheses might account for the parkinsonian features.…”