Severe multiple sclerosis reactivation under fingolimod 3 months after natalizumab withdrawal

Mult Scler. 2012 Nov;18(11):1647-9. doi: 10.1177/1352458512458009. Epub 2012 Aug 20.

Abstract

We report the case of a woman with multiple sclerosis who developed a severe neurological condition following natalizumab (NZB) withdrawal and soon after fingolimod (FTY) initiation. FTY was started 3.5 months after a two-year NZB treatment. Fifteen days later, she suffered partial repetitive seizures followed by a tonicoclonic seizure. This was associated with attention difficulties and an increased asthenia. Brain MRI follow-up disclosed large demyelinating active lesions in favour of disease reactivation. This case suggests that FTY introduction may occur less than three months after NZB withdrawal.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Asthenia / etiology
  • Disease Progression
  • Drug Administration Schedule
  • Drug Substitution*
  • Epilepsies, Partial / etiology
  • Epilepsy, Tonic-Clonic / etiology
  • Female
  • Fingolimod Hydrochloride
  • Humans
  • Immunologic Factors / administration & dosage*
  • Immunologic Factors / adverse effects
  • Magnetic Resonance Imaging
  • Multiple Sclerosis, Relapsing-Remitting / complications
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Natalizumab
  • Propylene Glycols / administration & dosage*
  • Severity of Illness Index
  • Sphingosine / administration & dosage
  • Sphingosine / analogs & derivatives*
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Immunologic Factors
  • Natalizumab
  • Propylene Glycols
  • Fingolimod Hydrochloride
  • Sphingosine