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Marburg’s variant of multiple sclerosis (MS) is a malignant and rapidly progressive form of MS that typically leads to deterioration or death within weeks to months. Here we present a case involving a 25-year-old woman who presented with fluctuating mild encephalopathy of one-week duration who progressed to coma and ultimately died on day seven after being admitted to our universitybased neurosciences intensive care unit (NSICU). During her stay, numerous studies were completed including a brain MRI with gadolinium which revealed multiple diffuse ring-enhancing lesions consistent with a fulminant demyelinating process, which was later supported by autopsy findings. CSF studies and serologies were essentially unremarkable. The rarity of Marburg’s variant of MS has resulted in a scarcity of literature and lack of clinical recommendations regarding management. After review of literature and with consideration of our case report, even when marked improvement following IV methylprednisolone is observed, adjunct therapy with a second modality should be considered to improve the chance of survival.

Marburg's Variant of Multiple Sclerosis with Extensive Brain Lesions: An Autopsy Case Report