What is tumefactive multiple sclerosis?

Tumefactive multiple sclerosis is a rare form of multiple sclerosis (MS). MS is a disabling and progressive disease that affects the central nervous system. The central nervous system is made up of the brain, spinal cord, and optic nerve.

MS occurs when the immune system attacks myelin, a fatty substance that coats nerve fibers. This attack causes scar tissue, or lesions, to form on the brain and spinal cord. Damaged nerve fibers interfere with normal signals from the nerve to the brain. This results in the loss of body function.

Brain lesions are typically small in most types of MS. However, in tumefactive multiple sclerosis, lesions are larger than two centimeters. This condition is also more aggressive than other types of MS.

Tumefactive MS is difficult to diagnosis because it causes symptoms of other health problems such as stroke, a brain tumor, or brain abscess. Here’s what you need to know about this condition.

Tumefactive multiple sclerosis can cause symptoms that are different from other types of MS. Common symptoms of multiple sclerosis include:

Symptoms more common in tumefactive multiple sclerosis include:

  • cognitive abnormalities, such as trouble learning, remembering information, and organizing
  • headaches
  • seizures
  • speech problems
  • sensory loss
  • mental confusion

There’s no known cause of tumefactive MS. Researchers do believe there are several factors that can increase your risk of developing this and other forms of MS. These include:

  • genetics
  • your environment
  • your location and vitamin D
  • smoking

You’re more likely to develop this condition if your parent or sibling has been diagnosed with the disease. Environmental factors may also play a role in the development of MS.

MS is also more common in areas that are farther from the equator. Some researchers think there’s a connection between MS and low exposure to vitamin D. People who live closer to the equator receive higher amounts of natural vitamin D from sunlight. This exposure may strengthen their immune function and protect against the disease.

Smoking is another possible risk factor for tumefactive multiple sclerosis.

One theory is that some viruses and bacteria trigger MS because they can cause demyelination and inflammation. However, there isn’t enough evidence to prove that viruses or bacteria can trigger MS.

Diagnosing tumefactive MS can be challenging because symptoms of the disease are similar to those of other conditions. Your doctor will ask questions about your symptoms, and your personal and family medical history.

A variety of tests can confirm tumefactive MS. To begin, your doctor may order an MRI. This test uses pulses of radiowave energy to create a detailed picture of your brain and spinal cord. This imaging test helps your doctor identify the presence of lesions on your spinal cord or brain.

Small lesions can suggest other types of MS, while larger lesions may suggest tumefactive multiple sclerosis. However, the presence or lack of lesions doesn’t confirm or exclude MS, tumefactive or otherwise. The diagnosis of MS requires a thorough history, physical exam, and combination of tests.

Other medical tests include a nerve function test. This measures the speed of electrical impulses through your nerves. Your doctor may also complete a lumbar puncture, otherwise known as a spinal tap. In this procedure, a needle is inserted in your lower back to remove a sample of cerebrospinal fluid. A spinal tap can diagnose a variety of medical conditions. These include:

  • serious infections
  • certain cancers of the brain or spinal cord
  • central nervous system disorders
  • inflammatory conditions that affect the nervous system

Your doctor may also order blood work to check for diseases that have symptoms similar to MS.

Because tumefactive MS can present itself as a brain tumor or central nervous system lymphoma, your doctor may suggest a biopsy of brain lesions if they’re seen on an MRI. This is when a surgeon removes a sample from one of the lesions.

There’s no cure for tumefactive multiple sclerosis, but there are ways to manage symptoms and slow its progression. This form of MS responds well to high doses of corticosteroids. These medications reduce inflammation and pain.

Several disease-modifying agents are also used to treat MS. These medications reduce the activity and slow the progression of tumefactive MS. You can receive medications orally, through injections, or intravenously under the skin or directly into your muscles. Some examples include:

  • glatiramer (Copaxone)
  • interferon beta-1a (Avonex)
  • teriflunomide (Aubagio)
  • dimethyl fumarate (Tecfidera)

Tumefactive MS can cause other symptoms, such as depression and frequent urination. Ask your doctor about medications to manage these specific symptoms.

Lifestyle treatments

Lifestyle modifications and alternative therapies can also help you manage the disease. Moderate exercise can improve:

  • fatigue
  • mood
  • bladder and bowel function
  • muscle strength

Aim for 30 minutes of exercise at least three times a week. You should first talk to your doctor before beginning a new exercise regimen, however.

You can also practice yoga and meditation to help manage stress. Mental and emotional stress can worsen symptoms of MS.

Another alternative treatment is acupuncture. Acupuncture may effectively relieve:

  • pain
  • spasticity
  • numbness
  • tingling
  • depression

Ask your doctor about physical, speech, and occupational therapy if the disease limits your movement or affects body function.

Tumefactive multiple sclerosis is a rare disease that can be very difficult to diagnose. It can progress and become debilitating without proper treatment. Treatment can help you manage the symptoms of this condition.

The disease may eventually progress to relapsing-remitting multiple sclerosis. This refers to periods of remission where symptoms disappear. Because the disease isn’t curable, flare-ups are possible from time to time. But once the disease is in remission, you may go months or years without symptoms and live an active, healthy life.

One study in 2015 showed that after five years, one-third of people diagnosed with tumefactive MS developed other types of MS. This included relapsing-remitting multiple sclerosis or primary progressive multiple sclerosis. Two-thirds had no further events.