Multiple sclerosis (MS) is a disabling and progressive disease that affects the central nervous system (CNS). The CNS 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 can be larger and even put pressure on the brain like a tumor.
Tumefactive multiple sclerosis is a rare form of the condition, affecting one or two out of every 1,000 people with MS. Tumefactive multiple sclerosis is also more aggressive than other forms of MS.
Tumefactive multiple sclerosis is difficult to diagnose because it causes the same symptoms as other health problems, such as stroke, a brain tumor, or brain abscess. Here’s what you need to know about this condition.
Tumefactive MS can cause symptoms that are different from other types of MS. Common MS symptoms include:
- numbness or tingling
- muscle weakness
- dizziness or vertigo
- bowel and bladder problems
- difficulty walking
- muscle spasticity
- vision problems
Symptoms more common in tumefactive MS include:
There’s no known cause of tumefactive MS.
Researchers do believe there are several factors that can increase your risk for developing this and other forms of MS. These include:
- your environment or geographic location
- your vitamin D levels
You’re more likely to develop MS if your parent or sibling has been diagnosed with the condition.
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 condition.
Smoking is another possible risk factor for MS, including tumefactive MS.
Another 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 as well as your personal and family medical history.
A variety of tests can be used to confirm tumefactive MS.
To begin, your doctor may order an MRI. This imaging test uses pulses of radiowave energy to create a detailed picture of your brain and spinal cord. It helps your doctor identify the presence of lesions on your brain or spinal cord.
Small lesions can suggest other types of MS, while larger lesions may suggest tumefactive MS. 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.
Because tumefactive MS can present itself as a brain tumor or CNS lymphoma, your doctor may suggest a biopsy of brain lesions if they’re seen on an MRI. A biopsy is when a surgeon removes a sample from one of the lesions.
Other medical tests include a nerve conduction study. 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 be used to diagnose a variety of medical conditions, including:
- serious infections
- certain cancers of the brain or spinal cord
- inflammatory conditions that affect the nervous system
Your doctor may also order blood work to check for conditions that have symptoms similar to MS.
There’s no cure for any type of MS, but there are ways to manage symptoms and slow its progression. Tumefactive MS responds well to high doses of corticosteroids. These medications reduce inflammation and pain.
Tumefactive MS may eventually progress into relapsing-remitting multiple sclerosis (RRMS). Remission refers to periods where symptoms disappear.
Once a person has developed RRMS, disease-modifying therapies (DMTs) can be initiated. These medications reduce the activity and slow the progression of MS.
You can receive DMTs orally, through injections, or intravenously under the skin or directly into your muscles. Some examples include:
- dimethyl fumarate (Tecfidera)
- glatiramer acetate (Copaxone, Glatopa)
- interferon beta-1a (Avonex, Rebif)
- ofatumumab (Kesimpta)
- teriflunomide (Aubagio)
Tumefactive MS can cause other symptoms, such as depression and frequent urination. Ask your doctor about medications to manage these specific symptoms.
Lifestyle modifications and complementary therapies can also help you manage MS. Moderate exercise can improve:
- bladder and bowel function
- muscle strength
Aim for 30 minutes of exercise at least three times per week. However, talk with your doctor first before beginning a new exercise regimen.
Another alternative treatment is acupuncture. Acupuncture may effectively relieve:
Tumefactive MS is a rare condition that can be very difficult to diagnose. Without proper treatment, it can progress and become debilitating. Treatment can help you manage the symptoms of this condition.
The condition may eventually progress to RRMS.
Because MS doesn’t have a cure, flare-ups are possible from time to time. Once the disease is in remission, you may go months or years without symptoms and live an active, healthy life.