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 is caused 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 small in other types of MS. 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.
Symptoms of tumefactive multiple sclerosis
Tumefactive multiple sclerosis can cause symptoms that are different from other types of MS. These include:
- numbness or tingling
- muscle weakness
- bowel and bladder problems
- difficulty walking
- muscle spasticity
- vision problems
Symptoms of tumefactive multiple sclerosis may include:
- cognitive abnormalities, such as trouble learning, remembering information, and organizing
- speech problems
- sensory loss
- mental confusion
What is the cause of tumefactive multiple sclerosis?
There is no known cause of tumefactive MS. Researchers believe there are several factors that can increase your risk of developing this and other forms of MS.
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 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.
There isn’t enough evidence to prove that viruses and bacteria trigger MS. However, this is a theory because some viruses and bacteria can cause demyelination and inflammation.
Diagnosing tumefactive multiple sclerosis
Diagnosing tumefactive multiple sclerosis is difficult 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 multiple sclerosis. To begin, your doctor may order an MRI. This test uses pulses of radio wave 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. But the discovery of lesions doesn’t mean you have MS, tumefactive or otherwise. You’ll have to complete more testing to confirm a diagnosis.
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, also called a spinal tap. 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, you doctor may suggest a biopsy. This is when a surgeon removes a sample from one of the lesions.
How is tumefactive multiple sclerosis treated?
There’s no cure for tumefactive multiple sclerosis, but there are ways to treat it. This form of MS responds well to high doses of corticosteroids. These medications reduce inflammation and pain.
The U.S. Food and Drug Administration has also approved several disease-modifying agents. These medications reduce the activity and slow the progression of tumefactive multiple sclerosis. 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 multiple sclerosis can cause other symptoms, such as depression and frequent urination. Ask your doctor about medications to manage these specific symptoms.
Lifestyle modifications and alternative therapies can also help you manage the disease. Moderate exercise can improve:
- bladder and bowel function
- strengthen your muscles
Aim for 30 minutes of exercise at least three times a week. Talk to your doctor before beginning a new exercise regimen.
You can also practice yoga and meditation to help manage stress. Mental and emotional stress can worsen symptoms of MS. Acupuncture may effectively relieve:
Ask your doctor about physical, speech, and occupational therapy if the disease limits movement or affects body function.
Outlook for tumefactive multiple sclerosis?
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. The disease isn't cured, so 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 showed that after 5 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. However, two-thirds had no further events.