Monofocal acute inflammatory Demyelination (MAID): a unique disorder simulating brain neoplasm.
BACKGROUND
Monofocal acute inflammatory demyelinating (MAID) lesions present as large masses that mimic brain tumors. The natural history and nosologic classification are not well defined.


METHODS
Five patients with MAID from our files and 4 from the literature are presented. We defined MAID as a mass-like lesion, >4 cm in diameter. Demyelination was pathologically proven in all patients.


RESULTS
Headaches and motor deficits were the most common presenting symptoms. Language problems and motor deficits were the most common findings on physical examination. After a median follow-up of 44 months, none of our 5 patients had multiple sclerosis. In similar cases, additional lesions indicative of multiple sclerosis developed within an average of 8 months.


CONCLUSIONS
It may be difficult to distinguish MAID from brain tumor. It may be that MAID represents a unique form of isolated demyelinating disease, or it may represent transition to multiple sclerosis.
Gutrecht
José A
JA
Department of Neurology, Lahey Clinic Medical Center, Burlington, Mass, USA.
Berger
Joseph R
JR
Jones
Royden H
RH
Mancall
Andrew C
AC
D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis*; D003711:Demyelinating Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis