title: Tumefactive demyelination following in vitro fertilization (IVF).
abstract: Tumefactive demyelination (TD) is a solitary cerebral demyelinating lesion clinically and radiologically mimicking brain tumors. It can occur in isolation or may be rarely associated with other demyelinating diseases. The underlying pathogenic mechanisms are unknown. We present the first report of TD following in-vitro fertilization (IVF) in a 36-year-old healthy woman who developed subacute right hemiparesis shortly after a scheduled IVF cycle. Evaluation revealed left hemispheric space-occupying lesion pathologically diagnosed as TD. Treatment with intravenous methylprednisolone promptly resulted in a clinical and radiological improvement maintained thereafter. This report confirms and expands the spectrum of inflammatory demyelinating conditions associated with IVF and suggests possible hormonal influence in the development of TD.
authors.affiliation: Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel. Electronic address: adembinsky@gmail.com.
authors.forename: Adi
authors.initials: A
authors.lastname: Vaknin-Dembinsky
authors.affiliation: Department of Gynecology and Obstetrics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bdolah
authors.affiliation: Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karussis
authors.affiliation: Department of Neurosurgery, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
authors.forename: Guy
authors.initials: G
authors.lastname: Rosenthal
authors.affiliation: Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
authors.forename: Panayiota
authors.initials: P
authors.lastname: Petrou
authors.affiliation: Department of Pathology, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
authors.forename: Yakov
authors.initials: Y
authors.lastname: Fellig
authors.affiliation: Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Abramsky
authors.affiliation: Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lossos
mesh_terms: D000328:Adult; D003711:Demyelinating Diseases / Q000209:etiology* / Q000473:pathology*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans
keywords: CNS demyelination; GnRH agonist; In vitro fertilization (IVF); Multiple sclerosis; Neuroinflammation; Tumefactive demyelination