Brain radiation and possible presentation of multiple sclerosis
A 43-year-old woman was admitted to hospital 2 years ago complaining of progressive generalized headache and bilateral blurred vision, with no history of hemiparesis or seizure. Her past medical and familial history was unremarkable for any neurological disorders or other disease. General clinical assessment was within normal limits. Laboratory exams were also found to be normal. Neurological exam, including visual field and ophthalmoscopy was within normal limits; on her magnetic resonance imaging (MRI) of brain a tumor in optic chiasm was observed.\nThe mass was restricted and surgically removed. Histological examination revealed meningothelial meningioma, and a diagnosis of meningioma was confirmed. Patient underwent 28 session of radiotherapy and 15 months after the last session of radiotherapy there was no sign of meningioma.\nNine months after the last session of radiotherapy she was referred to the clinic complaining of blurring vision in the right eye. General clinical assessment was normal. Neurological examination revealed visual acuity of 20/200 in right eye, increased deep tendon reflexes (3+) and also bilateral extensor plantar reflexes. The remaining neurological examination and fundoscopy was normal. On her MRI, radiological finding showed multiple lesions in periventricular, centrum semiovale and corpus callosum [] in which it showed compatibility with a diagnosis of MS according to 2005 MC Donald's criteria.\nDrug therapy for MS with beta-interferon 1a (Avonex) was begun.