Figure 1 MRIs (case 1)‏ MRIs (case 1) An enlarging T2 lesion in the cerebral white matter near the angular gyrus and a new lesion in the left middle cerebellar.

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Presentation transcript:

Figure 1 MRIs (case 1)‏ MRIs (case 1) An enlarging T2 lesion in the cerebral white matter near the angular gyrus and a new lesion in the left middle cerebellar peduncle in the first patient were initially interpreted as a clinically silent MS activity. Follow-up MRI 4 weeks later revealed punctate contrast enhancement, compatible with immune reconstitution inflammatory syndrome. Despite repeated intravenous methylprednisolone pulses (black arrowheads), 2 further IRIS episodes (8 and 20 weeks after onset) have been found by serial MRIs (red arrows). IRIS = immune reconstitution inflammatory syndrome; IVMP = IV methylprednisolone. Jin Nakahara et al. Neurol Neuroimmunol Neuroinflamm 2019;6:e559 Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.