title: Neuromyelitis Optica Spectrum Disorder with Tumefactive Demyelination mimicking Multiple Sclerosis: A Rare Case.
abstract: Neuromyelitis optica spectrum disorder (NMOSD) is a diverse condition which not only encompasses isolated longitudinally extensive transverse myelitis (LETM) and optic neuritis but also includes area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy or acute diencephalic clinical syndrome, and symptomatic cerebral syndrome. Imaging may reveal periependymal lesions surrounding the ventricular system or involvement of corticospinal tracts, area postrema, diencephalon, and corpus callosum. Rarely, there may be hemispheric tumefactive lesions that enhance in a "Cloud-like" fashion on gadolinium injection unlike in tumefactive multiple sclerosis where there is incomplete ring enhancement. Here, we present a case of aquaporin-4 positive relapsing NMOSD who presented to us with recurrent episodes of paraparesis with LETM and tumefactive lesions of brain on imaging, which enhanced in an incomplete ring like pattern resembling multiple sclerosis.
authors.affiliation: Department of Neurology, Bangur Institute of Neurosciences, The Institute of Post-Graduate Medical Education and Research , Kolkata , India.
authors.forename: Ujjawal
authors.initials: U
authors.lastname: Roy
authors.affiliation: Department of Neurology, Bangur Institute of Neurosciences, The Institute of Post-Graduate Medical Education and Research , Kolkata , India.
authors.forename: Dinesh Satyanarayan
authors.initials: DS
authors.lastname: Saini
authors.affiliation: Department of Neurology, Bangur Institute of Neurosciences, The Institute of Post-Graduate Medical Education and Research , Kolkata , India.
authors.forename: Koushik
authors.initials: K
authors.lastname: Pan
authors.affiliation: Department of Neurology, Bangur Institute of Neurosciences, The Institute of Post-Graduate Medical Education and Research , Kolkata , India.
authors.forename: Alak
authors.initials: A
authors.lastname: Pandit
authors.affiliation: Department of Neurology, Bangur Institute of Neurosciences, The Institute of Post-Graduate Medical Education and Research , Kolkata , India.
authors.forename: Goutam
authors.initials: G
authors.lastname: Ganguly
authors.affiliation: Department of Neurology, King George's Medical University , Lucknow , India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Panwar
keywords: aquaporin-4; longitudinally extensive transverse myelitis; neuromyelitis optica spectrum disorder; therapeutic plasma exchange; tumefactive multiple sclerosis