Brain leptomeningeal enhancement and cranial nerve enhancement in a pediatric-onset multiple sclerosis patient during fingolimod rebound: A case report

Neuroimmunology Reports Pub Date : 2024-11-01 DOI:10.1016/j.nerep.2024.100232

Nikoloz Karazanashvili , Monica M. Diaz , Jorge L. Almodovar , Bushra Javed , Stephanie Iyer , Irena Dujmovic Basuroski

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Abstract

We report a case of leptomeningeal and trigeminal nerve enhancement in an African American male patient with pediatric onset (age 17) relapsing-remitting multiple sclerosis (MS) during fingolimod rebound. The patient was clinically and radiologically stable while on fingolimod for 3.5 years, but developed disease rebound following fingolimod self-discontinuation. During this episode, several new T2/fluid-attenuated inversion recovery (FLAIR) lesions, enlarging T2/FLAIR lesions and contrast-enhancing lesions in the brain (supratentorial, cerebellum, brainstem) and spinal cord, enhancement of both trigeminal nerves and mild leptomeningeal enhancement (LME) around the brainstem were seen on brain magnetic resonance imaging (MRI). LME or cranial nerve enhancement (CNE) were not present on prior MRI studies, or on MRI studies performed after the patient recovered from fingolimod rebound. LME and CNE in MS may occur during rebound MS activity following fingolimod discontinuation as a transient phenomenon.

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一名儿科多发性硬化症患者在芬戈莫德反弹期间出现脑膜强化和颅神经强化：病例报告

我们报告了一例非裔美国男性小儿起病（17 岁）复发缓解型多发性硬化症（MS）患者在芬戈莫德反弹期间出现的脑膜和三叉神经增强病例。该患者在服用芬戈莫德 3.5 年期间临床和影像学表现稳定，但在芬戈莫德自行停药后出现了病情反弹。在此期间，脑磁共振成像（MRI）出现了几个新的T2/流体增强反转恢复（FLAIR）病灶、扩大的T2/FLAIR病灶以及大脑（上脑室、小脑、脑干）和脊髓的对比度增强病灶、两侧三叉神经增强和脑干周围轻度脑膜强化（LME）。LME或颅神经强化（CNE）在之前的核磁共振成像检查中没有出现，在患者从芬戈莫德反弹中恢复后进行的核磁共振成像检查中也没有出现。多发性硬化症患者的LME和CNE可能会在芬戈莫德停药后多发性硬化症活动反弹期间出现，这是一种短暂现象。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Neuroimmunology Reports

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