Thirty-one patients with large, focal cerebral demyelinating lesions are reported from the University of Kansas School of Medicine, Kansas City. The lesions presented clinically and radiologically as brain tumors or as multiple cysts. The demyelinating pathology was established through biopsy and a significant improvement with corticosteroid therapy. Four patients were children, ages 8-12 years, and one was an adolescent, aged 18. One young adult had received an influenza vaccine 10 days before the onset of symptoms. The clinical course favored postinfectious/postvaccination encephalitis, but the tumor-sized masses of demyelination were atypical. [1]
COMMENT. The author rules out Schilder’s disease, a progressive child-hood diffuse sclerosis, which often presents with asymmetrical, large focal hemispheric lesions and smaller lesions, sometimes difficult to differentiate from multiple sclerosis. (See Greenfield’s Neuropathology, Baltimore, Williams and Wilkins, 1963). Many reported cases of Schilder’s disease are now thought to represent either adrenoleuko-dystrophy or acute forms of multiple sclerosis. [2]