Moyamoya Disease Can Masquerade as Multiple Sclerosis

Dorfman, Leslie J.; Fischbein, Nancy J.; Woodard, Joslyn I.; Choudhri, Omar; Bell-Stephens, Teresa

doi:10.1097/nrl.0b013e31826a99a1

Cited by 13 publications

(8 citation statements)

References 16 publications

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“…Multiple sclerosis (MS) is an inflammatory disease of the white matter of the brain characterized by relapsing neurological symptoms. The masquerade between those diseases is high, but the clinical, radiological and laboratory investigations confirm that both pathologies were present in our patient, although this is not reported before 4 . The studies emphasize early consideration of Moyamoya in the differential diagnosis of MS-spectrum disorders, which shares many features 4,5 .…”

supporting

confidence: 60%

“…It was found that most cases initially are considered being compatible with multiple sclerosis; stroke and the typical angiography finding change the diagnosis to Moyamoya and this is a unique about our case report 4,5,11 .…”

Section: Discussionmentioning

confidence: 62%

“…Hemorrhagic stroke could happen in these cases due to rupture of the collaterals. Although Moyamoya disease and MS have a different pathophysiology, both of them could share the same presentation of recurrent neurological symptoms leading to misdiagnosis as reported in the litreature 4 .…”

Section: Discussionmentioning

confidence: 99%

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Moyamoya Disease in Patient with Multiple Sclerosis

Shamrani¹,

Alkhamis²,

Ghanimi³

2015

BMB

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Moyamoya disease is a chronic occlusion of a major vessel of the circle of Willis leading to opening of cerebral collaterals. Moyamoya is common in Japan, but cases from Europe and America were reported 1. Its etiology could be idiopathic (primary Moyamoya), secondary (inherited), hematological and post infections 2. It has a special characteristic appearance in the angiography described as "puff of smoke" 3 .

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supporting

confidence: 60%

Section: Discussionmentioning

confidence: 62%

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Moyamoya Disease in Patient with Multiple Sclerosis

Shamrani¹,

Alkhamis²,

Ghanimi³

2015

BMB

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“…Some clinicians have effectively combined in the treatment of MMD and emphasized the roles of temporalis, dura mater, and superficial temporal artery (STA) in blood supply. The symptoms of cerebral ischemia and epilepsy are alleviated significantly in most patients after successful implementation of revascularization (Bao et al, 2012;Dorfman et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Treatment of moyamoya disease by multipoint skull drilling for indirect revascularization combined with mobilization of autologous bone marrow stem cells

Wu¹,

N²,

Zhang³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. This study discusses the clinical efficacy of multipoint skull drilling for indirect revascularization combined with mobilization of autologous bone marrow stem cells and use of simvastatin in the treatment of moyamoya disease. Seventy-eight patients [control group (group A), 39 patients; experimental group (group B), 39 patients] with moyamoya disease were selected. Group A underwent indirect revascularization, and group B, in addition to indirect revascularization, received alternate subcutaneous injections from day 7 post-surgery. The number and differentiation of the mobilized bone marrow stem cells were detected by the proportion of hematopoietic progenitor cell (HPCs) in mononuclear cells (MNCs) in the peripheral blood. There was no statistical difference in the BI (80.2 ± 13.7) and NIHSS (6.7 ± 2.3) scores between the groups before treatment (P > 0.05). The CSS R.Wu et al. 7520©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (3): 7519-7528 (2015) score of group B was 13.5 ± 0.6 and there was a statistical significance compared to group A (18.2 ± 0.8) (P < 0.05). There was no statistical difference in the proportion of CD34+ CDl33+ cells in MNCs in peripheral blood before surgery between the two groups (P > 0.05) and the proportions of CD34+ CDl33+ cells in MNCs in peripheral blood in groups A and B at 30 days after surgery were significantly higher than those before surgery (P < 0.05). Treating moyamoya disease by multipoint skull drilling for indirect revascularization combined with mobilization of autologous bone marrow stem cells and simvastatin is a safe and effective method as it can promote recovery of neurological functions and improve patients' daily living abilities and quality of life.

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“…Here is the basis for differential diagnosis. Firstly, MM commonly has paroxysmal onset and recovers within 24 h, whereas MS attacks may progress in a subacute manner after several days (7). Secondly, the clinical presentations of MM include transient ischemic attacks, ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment (23).…”

Section: Ob (+) Vep (+) Dissemination Of Lesions In Space (Dis) Anmentioning

confidence: 99%

A Patient With Multiple Sclerosis and Coexisting Moyamoya Disease: Why and How

Fang

et al. 2020

Front. Neurol.

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Introduction: Multiple sclerosis (MS) and moyamoya (MM) are two separate diseases that rarely coexist. A special case with the two diseases coexisting was reported herein, and previously published articles were reviewed to investigate the clinical manifestations, management, outcomes, and underlying pathogenesis. Patient concerns: A 42-year-old male presented with gradual right limb weakness and slow response for 3 months. However, these symptoms abruptly progressed during his hospital stay. Diagnosis: This patient was diagnosed with coexisting MS and MM finally. The diagnosis of MS was made according to McDonald criteria of multiple lesions and multiple time episodes. Meanwhile, cerebral angiography indicated the diagnosis of MM. Interventions: This patient was treated with methylprednisolone and antiplatelet drug and received bilateral superficial temporal artery bypass surgery for the occulted artery. Outcomes: This patient's right limbs recovered to 4/5-grade muscle strength after 1 month of follow-up after hospital discharge, and his speech function improved after 3 months after hospital discharge. Conclusion: We reported a rare scenario in a patient with the coexistence of MS and MM. We suspect that MS might induce immune response that plays a role in the pathogenesis of MM, while MM might accelerate the demyelination of MS. However, the pathogenesis and therapeutics of MM and MS coexistence need further investigation.

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Moyamoya Disease Can Masquerade as Multiple Sclerosis

Abstract: MM can be misdiagnosed as MS, leading to delay in correct treatment. We highlight the clinical and radiologic features which allow differentiation of these conditions early in the course, when treatment can have maximum benefit.

Cited by 13 publications

References 16 publications

Moyamoya Disease in Patient with Multiple Sclerosis

Moyamoya Disease in Patient with Multiple Sclerosis

Treatment of moyamoya disease by multipoint skull drilling for indirect revascularization combined with mobilization of autologous bone marrow stem cells

A Patient With Multiple Sclerosis and Coexisting Moyamoya Disease: Why and How

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