Article Figures & Data
Figures
- Figure 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.
- Figure 2 MRIs (cases 2 and 3)
In both the second and third cases, MRI performed because of clinical deterioration revealed highly progressive multifocal leukoencephalopathy-suspicious T2 lesions involving subcortical U-fibers (A, D), without a contrast enhancement in T1 (B). Follow-up MRI 4 weeks later revealed massive progression in a second patient (C, no contrast enhancement imaging performed) and only moderate enlargement in the left hemisphere in a third one (E) with discretfully scattered punctate contrast enhancement in the margins of the right-sided lesion (red arrow) consistent with a milder immune reconstitution inflammatory syndrome (F).
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