Tumefactive demyelination following in vitro fertilization (IVF)

Adi Vaknin-Dembinsky; Yuval Bdolah; Dimitrios Karussis; Guy Rosenthal; Panayiota Petrou; Yakov Fellig; Oded Abramsky; Alexander Lossos

doi:10.1016/j.jns.2014.11.016

Tumefactive demyelination following in vitro fertilization (IVF)

J Neurol Sci. 2015 Jan 15;348(1-2):256-8. doi: 10.1016/j.jns.2014.11.016. Epub 2014 Nov 18.

Authors

Adi Vaknin-Dembinsky¹, Yuval Bdolah², Dimitrios Karussis³, Guy Rosenthal⁴, Panayiota Petrou³, Yakov Fellig⁵, Oded Abramsky³, Alexander Lossos³

Affiliations

¹ Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel. Electronic address: adembinsky@gmail.com.
² Department of Gynecology and Obstetrics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
³ Department of Neurology, Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
⁴ Department of Neurosurgery, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.
⁵ Department of Pathology, Hadassah-Hebrew University, Medical Center, Ein-Karem, Jerusalem 91120, Israel.

PMID: 25499758
DOI: 10.1016/j.jns.2014.11.016

Abstract

Tumefactive demyelination (TD) is a solitary cerebral demyelinating lesion clinically and radiologically mimicking brain tumors. It can occur in isolation or may be rarely associated with other demyelinating diseases. The underlying pathogenic mechanisms are unknown. We present the first report of TD following in-vitro fertilization (IVF) in a 36-year-old healthy woman who developed subacute right hemiparesis shortly after a scheduled IVF cycle. Evaluation revealed left hemispheric space-occupying lesion pathologically diagnosed as TD. Treatment with intravenous methylprednisolone promptly resulted in a clinical and radiological improvement maintained thereafter. This report confirms and expands the spectrum of inflammatory demyelinating conditions associated with IVF and suggests possible hormonal influence in the development of TD.

Keywords: CNS demyelination; GnRH agonist; In vitro fertilization (IVF); Multiple sclerosis; Neuroinflammation; Tumefactive demyelination.

Publication types

Case Reports

MeSH terms

Adult
Demyelinating Diseases / etiology*
Demyelinating Diseases / pathology*
Female
Fertilization in Vitro / adverse effects*
Humans