Issue 1/2025
Aleksandrova1,2, I., Topalov1,2, N., Slavkova1, E., Bozhinova1, V.
1 Clinic for Children‘s Neurological Diseases, St. Naum University Hospital – Sofia
2 Department of Neurology, Sofia Medical University – Sofia
3 Department of Imaging Diagnostics
Atypical demyelinating lesions in patients with multiple sclerosis (MS) (tumor-like demyelinating lesions, white matter cavitation lesions, leukodystrophy-like lesions), although rare, pose serious differential diagnostic and therapeutic problems. Tumor-like demyelinating lesions are larger than 2 cm, may be solitary or associated with other tumor-like lesions and/or with lesions typical of MS. They have been described in a large group of idiopathic demyelinating diseases of the central nervous system – MS, clinically isolated syndrome (CIS), rare variants of MS (Schilder‘s disease, acute Marburg and Balo‘s concentric sclerosis), acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, neuromyelitis optica. The development of magnetic resonance imaging allows early and correct diagnosis of atypical imaging findings in MS. The presence of other typical MS lesions, as well as oligoclonal data, are risk factors for subsequent relapses. In cases where the diagnostic criteria for MS are met, initiation of disease-modifying therapy is recommended.
Key words: tumor-like demyelinating lesions, Balo‘s concentric sclerosis, multiple sclerosis
Address for correspondence:
Assoc. Prof. Dr. Iliyana Alexandrova, MD
Clinic of Neurological Diseases for Children,
„St. Naum“ Hospital
1, „Lyuben Rusev“, Str.
1113, Sofia
e-mail: iliyana_@abv.bg