First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old woman
Key Clinical Message This case highlights a rare form of solitary sclerosis with a relapsing pattern, contrasting with the typical single attack and nonrelapsing nature of the disease. Despite the lack of new lesions on MRI, This case demonstrates that, despite the rarity of this variant, a relapsin...
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| Format: | Article |
| Language: | English |
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Wiley
2024-11-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.9546 |
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| author | Elnaz Asadollahzadeh Vahid Shahmaei Zahra Ebadi Mohammad‐Sadegh Johari Nasim Rezaeimanesh Abdorreza Naser Moghadasi |
| author_facet | Elnaz Asadollahzadeh Vahid Shahmaei Zahra Ebadi Mohammad‐Sadegh Johari Nasim Rezaeimanesh Abdorreza Naser Moghadasi |
| author_sort | Elnaz Asadollahzadeh |
| collection | DOAJ |
| description | Key Clinical Message This case highlights a rare form of solitary sclerosis with a relapsing pattern, contrasting with the typical single attack and nonrelapsing nature of the disease. Despite the lack of new lesions on MRI, This case demonstrates that, despite the rarity of this variant, a relapsing form of solitary sclerosis can occur and should be considered a differential diagnosis. Abstract Progressive solitary sclerosis is characterized by isolated demyelinating damage to the central nervous system in the spinal cord and brainstem, leading to progressive motor impairment. We describe the case of a 49‐year‐old woman who suffered several recurrent attacks of right hemiparesis over time. The patient initially responded well to methylprednisolone pulse therapy without maintenance therapy. However, subsequent episodes resulted in mild residual symptoms and the progression of her condition. Clinical examination revealed normal cranial nerve function, decreased sensation in the right limbs, and abnormal signal findings on MRI of the cervical spine. Laboratory tests, vasculitis screening, cerebrospinal fluid (CSF) analysis, and brain/spinal cord angiography were all within normal limits. Based on these findings and the patient's clinical presentation, a diagnosis of progressive solitary sclerosis with relapsing attacks was made. Rituximab treatment was initiated with administration of a first dose of 1000 mg, followed by a second dose 6 months later. |
| format | Article |
| id | doaj-art-e7c55db4649a4de98b71a1a61a4c09bb |
| institution | Kabale University |
| issn | 2050-0904 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-e7c55db4649a4de98b71a1a61a4c09bb2024-11-25T12:48:37ZengWileyClinical Case Reports2050-09042024-11-011211n/an/a10.1002/ccr3.9546First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old womanElnaz Asadollahzadeh0Vahid Shahmaei1Zahra Ebadi2Mohammad‐Sadegh Johari3Nasim Rezaeimanesh4Abdorreza Naser Moghadasi5Multiple Sclerosis Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran IranMAHAK Hematology Oncology Research Center (MAHAK‐HORC), MAHAK Hospital Shahid Beheshti University of Medical Sciences Tehran IranMultiple Sclerosis Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran IranDepartment of Radiology, Faculty of Medicine Aja University of Medical Sciences Tehran IranMultiple Sclerosis Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran IranMultiple Sclerosis Research Center, Neuroscience Institute Tehran University of Medical Sciences Tehran IranKey Clinical Message This case highlights a rare form of solitary sclerosis with a relapsing pattern, contrasting with the typical single attack and nonrelapsing nature of the disease. Despite the lack of new lesions on MRI, This case demonstrates that, despite the rarity of this variant, a relapsing form of solitary sclerosis can occur and should be considered a differential diagnosis. Abstract Progressive solitary sclerosis is characterized by isolated demyelinating damage to the central nervous system in the spinal cord and brainstem, leading to progressive motor impairment. We describe the case of a 49‐year‐old woman who suffered several recurrent attacks of right hemiparesis over time. The patient initially responded well to methylprednisolone pulse therapy without maintenance therapy. However, subsequent episodes resulted in mild residual symptoms and the progression of her condition. Clinical examination revealed normal cranial nerve function, decreased sensation in the right limbs, and abnormal signal findings on MRI of the cervical spine. Laboratory tests, vasculitis screening, cerebrospinal fluid (CSF) analysis, and brain/spinal cord angiography were all within normal limits. Based on these findings and the patient's clinical presentation, a diagnosis of progressive solitary sclerosis with relapsing attacks was made. Rituximab treatment was initiated with administration of a first dose of 1000 mg, followed by a second dose 6 months later.https://doi.org/10.1002/ccr3.9546methylprednisolone pulse therapyrelapsing attacksrituximabsolitary sclerosis |
| spellingShingle | Elnaz Asadollahzadeh Vahid Shahmaei Zahra Ebadi Mohammad‐Sadegh Johari Nasim Rezaeimanesh Abdorreza Naser Moghadasi First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old woman Clinical Case Reports methylprednisolone pulse therapy relapsing attacks rituximab solitary sclerosis |
| title | First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old woman |
| title_full | First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old woman |
| title_fullStr | First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old woman |
| title_full_unstemmed | First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old woman |
| title_short | First case of progressive solitary sclerosis with relapsing attacks: A 49‐year‐old woman |
| title_sort | first case of progressive solitary sclerosis with relapsing attacks a 49 year old woman |
| topic | methylprednisolone pulse therapy relapsing attacks rituximab solitary sclerosis |
| url | https://doi.org/10.1002/ccr3.9546 |
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