Тяжелое течение рассеянного склероза под маской прогрессирующей мультифокальной лейкоэнцефалопатии (клиническое наблюдение)

Abstract

The article presents a retrospective case study concerning demyelinating disease in a 44-year-old female patient. The disease onset was in 2019 with minor clinical manifestations, however, it led to an exacerbation, clinically similar to acute disseminated encephalomyelitis, manifested by facial asymmetry, speech disorder, gait, and pelvic floor dysfunction. Diagnosis was significantly hindered, since the female patient herself was not sufficiently aware of the disease severity and was not interested in further treatment due to concomitant depressive disorder. The presented clinical case shows the importance of a multidisciplinary approach and the earliest possible diagnosis. Despite the fact that multiple sclerosis was suspected at the time of the disease's onset, diagnosis and treatment began only 2 years later, when persistent disabling disorders developed in female patient that required the use of a differential diagnostic sets with such nosologies as progressive multifocal leukoencephalopathy, acute disseminated encephalomyelitis, secondary encephalitis, levamisole-induced multifocal inflammatory leukoencephalopathy. The possibilities of laboratory and instrumental methods necessary for this disease verification were analyzed as part of the case study KEYWORDS: multiple sclerosis, progressive multifocal leukoencephalopathy, acute disseminated encephalomyelitis, differential diagnosis, case study FOR CITATION: Ershova A.A., Kotov A.S. Destructive course of multiple sclerosis under the mask of progressive multifocal leukoencephalopathy (case report). Russian Medical Inquiry. 2023;7(10):687–692 (in Russ.). DOI: 10.32364/2587-6821-2023-7-10-12.