A case of posterior reversible encephalopathy syndrome associated with gilenya(®) (fingolimod) treatment for multiple sclerosis

Frontiers in Neurology
Hans Lindå, Anders von Heijne

Abstract

We describe posterior reversible encephalopathy syndrome (PRES) in a woman with multiple sclerosis treated with Gilenya(®) (Fingolimod). The first symptoms appeared after 21 months of fingolimod treatment. She experienced headache, altered mental status, cognitive deficits, seizures, and visual disturbances. Not at any time during the course of the disease could any signs of infection or rheumatic disorder be detected. Test for anti-neuronal antibodies was also negative. Her blood pressure was normal. MRI showed widespread cortical and subcortical changes with some mass-effect in the temporo-occipital-parietal lobes in the left hemisphere. Contrast enhancement was seen in the leptomeninges and, in addition, there were no areas with restricted diffusion and no signs of hemorrhage. Her condition deteriorated until fingolimod was discontinued. Slowly her condition improved and after 8 months, the only symptoms that remained were two small, non-corresponding, right inferior scotomas. We believe that all symptoms, the clinical course, and the MRI findings in this case can all be explained by considering PRES, a probably rare, but serious, side effect of fingolimod treatment.

References

Jan 1, 1976·Acta Physiologica Scandinavica·A Bill, J Linder
Feb 22, 1996·The New England Journal of Medicine·J HincheyL R Caplan
May 29, 2004·Current Opinion in Neurology·Igor J Koralnik
Mar 3, 2006·The New England Journal of Medicine·Chris H PolmanUNKNOWN AFFIRM Investigators
Mar 3, 2006·The New England Journal of Medicine·Richard A RudickUNKNOWN SENTINEL Investigators
Mar 3, 2006·The New England Journal of Medicine·Tarek A YousryDavid B Clifford
Sep 15, 2006·The New England Journal of Medicine·Ludwig KapposUNKNOWN FTY720 D2201 Study Group
Sep 22, 2007·AJR. American Journal of Roentgenology·Alexander M McKinneyMehmet Teksam
Feb 13, 2008·Archives of Neurology·Vivien H LeeAlejandro A Rabinstein
Apr 12, 2008·Biochemical and Biophysical Research Communications·Vera Krump-KonvalinkovaWolfgang Siess
Sep 11, 2009·The New England Journal of Medicine·Hans LindåClaes Martin
Jan 22, 2010·The New England Journal of Medicine·Ludwig KapposUNKNOWN FREEDOMS Study Group
Jan 22, 2010·The New England Journal of Medicine·Jeffrey A CohenUNKNOWN TRANSFORMS Study Group
May 4, 2010·Mayo Clinic Proceedings·Jennifer E FugateAlejandro A Rabinstein
May 5, 2010·Neurology·Alejandro Sánchez-CarteyronJesús Martín
May 19, 2011·Seminars in Neurology·Steven K Feske
May 19, 2012·Multiple Sclerosis : Clinical and Laboratory Research·Bernhard F DécardRalf Gold
Dec 25, 2013·Handbook of Clinical Neurology·C LamyJ L Mas
Apr 22, 2014·Seminars in Ultrasound, CT, and MR·Jeffrey B Rykken, Alexander M McKinney
Jul 22, 2014·Journal of Clinical Neurology·Willemijn Huijgen, Geert Lycklama À Nijeholt

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Citations

Oct 27, 2015·Biochemistry·Jason Z NiehausCliff J Luke
May 22, 2017·Acta neurologica Belgica·Yara Dadalti Fragoso
Sep 22, 2017·Clinical & Experimental Neuroimmunology·Fumihito YoshiiWakoh Takahashi
Nov 25, 2020·Journal of Neurology, Neurosurgery, and Psychiatry·Martijn T WijburgMike P Wattjes

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