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Figure A 57-year-old man with relapsing-remitting MS (RRMS) and new-onset ataxia A 57-year-old man with relapsing-remitting MS (RRMS) and new-onset ataxia.

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Presentation on theme: "Figure A 57-year-old man with relapsing-remitting MS (RRMS) and new-onset ataxia A 57-year-old man with relapsing-remitting MS (RRMS) and new-onset ataxia."— Presentation transcript:

1 Figure A 57-year-old man with relapsing-remitting MS (RRMS) and new-onset ataxia
A 57-year-old man with relapsing-remitting MS (RRMS) and new-onset ataxia Axial fluid-attenuated inversion recovery (FLAIR) image of the posterior fossa (A) from March 2018 showed a new punctate enhancing lesion in the right cerebellar deep white matter (green arrow), which was disproportionate to the clinical cerebellar syndrome. September 2017 axial (B) and sagittal (C) FLAIR images compared with March 2018 axial (D) and sagittal (E) FLAIR images showed interval development of asymmetrical pathologic cerebellar atrophy with widened sulci (yellow arrows). Patchy cortical FLAIR hyperintensities were also observed in the cerebellar folia (purple arrow). (F–H) Coronal post-contrast T1-weighted images of the cerebellar hemisphere performed at 1-month intervals during the 2018 admission showed development of leptomeningeal and parenchymal enhancement (blue arrows) following withdrawal of natalizumab and after plasma exchange treatment suggestive of immune reconstitution inflammatory syndrome (IRIS). Partial resolution of the enhancement was also demonstrated subsequently following steroid therapy. David A. Lapides et al. Neurol Neuroimmunol Neuroinflamm 2019;6:e546 Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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