ArticleAnnals of clinical and translational neurology2023
Defining the natural history of tumefactive demyelination: A retrospective cohort of 257 patients.
Article in Annals of clinical and translational neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Biopsy-proven tumefactive demyelinating lesions: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- Progressive motor impairment from intracerebral critical demyelinating lesions.Journal of neurology · 2026Article
- Tumefactive Multiple Sclerosis Mimicking a High-Grade Glioma: A Case Report and Literature Review.Reports (MDPI) · 2026Article
- Article
- Non-Syndromic Tumefactive Demyelinating Lesions in the Pediatric Population: Four Case Reports and Review of the Literature.Annals of the Child Neurology Society · 2026Article
- The impact of adding optical coherence tomography in MS diagnostic criteria on the classification of tumefactive demyelination.Journal of the neurological sciences · 2026Observational
- Cerebral tumefactive demyelinating lesions: clinical spectrum, long-term outcomes, and treatment.Acta neurologica Belgica · 2026Article
- Tumefactive demyelinating lesions: a case report and literature review.BMC neurology · 2025Review
- Article
- Cervical cord atrophy correlates with intracranial lesion burden in tumefactive multiple sclerosis.Journal of neurology · 2025Article
- Genomewide association study of a homogeneous multiple sclerosis cohort: Tumefactive demyelination.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- Deep Learning MRI Models for the Differential Diagnosis of Tumefactive Demyelination versusAJNR. American journal of neuroradiology · 2025Article
- Long-term outcomes of ADEM-like and tumefactive presentations of CNS demyelination: a case-comparison analysis.Journal of neurology · 2024Article
- Article
- Tumefactive demyelination in older adults: A scoping review of published cases.Multiple sclerosis journal - experimental, translational and clinicalReview
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo describe demographic, clinical, and radiographic features of tumefactive demyelination (TD) and identify factors associated with severe attacks and poor outcomes.
methodsRetrospective review of TD cases seen at Mayo Clinic, 1990-2021.
resultsOf 257 patients with TD, 183/257 (71%) fulfilled the 2017 multiple sclerosis (MS) McDonald criteria at the last follow-up, 12/257 (5%) had myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), 0 had aquaporin-4-IgG seropositive neuromyelitis optic spectrum disorders (AQP4+ NMOSD), and 62/257 (24%) were cryptogenic. Onset before age 18 was present in 18/257 (7%). Female to male ratio was 1.3:1. Cerebrospinal fluid oligoclonal (CSF) bands were present in 95/153 (62%). TD was the first demyelinating attack in 176/257 (69%). At presentation, 59/126 (47%) fulfilled Barkhof criteria for dissemination in space, 59/100 (59%) had apparent diffusion coefficient (ADC) restriction, and 57/126 (45%) had mass effect. Despite aggressive clinical presentation at onset, 181/257 (70%) of patients remained fully ambulatory (Expanded Disability Status Scale [EDSS] ≤4) after a 3.0-year median follow-up duration. Severe initial attack-related disability (EDSS ≥4) was more common in patients with motor symptoms (81/143 vs. 35/106, p < 0.0001), encephalopathy (20/143 vs. 2/106, p < 0.0001) and ADC restriction on initial MRI (42/63 vs. 15/33, p = 0.04). Poor long-term outcome (EDSS ≥4) was more common in patients with older onset age (41.9 ± 15 vs. 36.8 ± 15.6, p = 0.02) and motor symptoms at onset (49/76 vs. 66/171, p < 0.0001).
interpretationMost TD patients should be considered part of the MS spectrum after excluding MOGAD and NMOSD. Motor symptoms and older age at presentation portend a poor outcome.
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