Tumefactive rebound of multiple sclerosis after the short-term cessation of fingolimod: A case report

Abstract

Rebound syndrome can occur as a flare-up disease activity after stopping treatment in multiple sclerosis (MS). A potential rebound activity has recently been reported after fingolimod cessation with increasing clinical and radiographic activity, which makes decision-making about the discontinuation of treatment a major concern. This article reports on a patient with tumefactive rebound of MS who presented with acute onset encephalopathy and progressive motor deficiencies a few days after fingolimod cessation. Despite the invasive treatment, the disease progressed and resulted in the patient's death. This article discusses the clinical course of the disease and the MRI findings and compares them with the findings of previous reports. The present case shows that rebound activity can occur even after a short-term fingolimod withdrawal and may present with acute onset encephalopathy and aphasia.