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Stroke after initiation of interferon‐beta treatment for relapsing–remitting disseminated white matter disease
Author(s) -
Bosche B.,
Dohmen C.,
Impekoven P.,
Weber O. Z.,
Reske D.,
Rubbert A.,
Jacobs A. H.,
Petereit H.F.
Publication year - 2006
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2006.00638.x
Subject(s) - medicine , multiple sclerosis , exacerbation , stroke (engine) , white matter , interferon beta 1a , magnetic resonance imaging , disease , positron emission tomography , cerebral infarction , pathology , radiology , interferon beta , ischemia , immunology , mechanical engineering , engineering
Background – Interferon‐beta (INF‐ β ) is effective and used in reducing exacerbation frequency and disease progression in multiple sclerosis. In certain circumstances, INF‐ β can lead to rare side effects. Aims of the study – We report the case of a 34‐year‐old female patient satisfying the McDonald criteria of multiple sclerosis without showing typical pathologic changes in cerebrospinal fluid (CSF). After introduction of INF‐ β treatment, she quickly developed further progression of her disseminated neurological symptoms and finally an ischemic cerebral infarction. Methods – Evaluation of the patient included arterial angiography, magnetic resonance and positron emission tomography, histopathological assessment as well as a broad spectrum of serum and CSF analysis. Results – All diagnostic evaluations and the clinical course revealed evidences for a primary angiitis of the CNS. We discuss the possible worsening due to inappropriate INF‐ β treatment in cerebral angiitis promoting severe cerebrovascular insufficiency. Conclusion – The authors suggest that all diagnostic multiple sclerosis criteria including typical CSF findings should be ascertained before INF‐ β treatment is initiated.