"MRI of the neuraxis reveals lesions consistent with demyelination (e.g. increased T2 signal) 1,3. Most commonly, these occur in the cerebrum (~75%) and spinal cord (~75%), however, can occur in the brainstem (~30%), cerebellum (~15%), and optic nerve(s) (~20%) 1. Simultaneous involvement of two or more sites is common (~70%), with the cerebrum and spinal cord being the most common combination 1."
"Brain lesions are typically multiple (>4), small ("
"medication-related: e.g. TNF-alpha inhibitors, immune checkpoint inhibitors"
Expected headings
"Central nervous system"
"Peripheral nervous system"
"visual disturbance (e.g. due to optic neuritis)"
"systemic autoimmune conditions: e.g. Sjögren disease, systemic lupus erythematosus, neurosarcoidosis, vasculitis, IgG4-related disease, anti-GQ1b antibody syndrome (e.g. Bickerstaff encephalitis)"
"Management is with immunosuppression, with various options described in the literature, most commonly including corticosteroids, intravenous immunoglobulin, plasma exchange, and rituximab 1-4,10. These agents may be used as monotherapies or in combination 1. Rituximab may be particularly useful in patients seropositive to anti-neurofascin 155 (anti-NF155), who may be poor responders to intravenous immunoglobulin 7,10."
"There is a broad clinicoradiological differential diagnosis 1,10:"