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       #Post#: 1499--------------------------------------------------
       (Abst.) Extensive white matter lesions after 2 yrs. of fingolimo
       d: PML or MS relapse?
       By: agate Date: December 26, 2016, 6:19 pm
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       From Multiple Sclerosis Journal, December 23, 2016:
       [quote]Extensive white matter lesions after 2 years of
       fingolimod: Progressive multifocal leukoencephalopathy or MS
       relapse?
       Marine Boudot de la Motte, Céline Louapre, Anne Bertrand,
       Pauline Reach, Catherine Lubetzki, Caroline Papeix, Elisabeth
       Maillart
       Background:
       Fingolimod is a widely used treatment for highly active
       relapsing–remitting multiple sclerosis.
       Objectives:
       To describe the case of a 27-year-old patient treated for more
       than 2 years by Fingolimod, who presented hemiplegia and
       speech disturbances associated with extensive white matter
       lesions on brain magnetic resonance imaging (MRI).
       Methods:
       Case study.
       Results:
       Although initial presentation questioned the possibility of
       progressive multifocal leukoencephalopathy, final diagnosis was
       multiple sclerosis (MS) relapse. Appropriate treatment resulted
       in clinical and radiological improvement.
       Conclusion:
       Severe MS relapses under Fingolimod have been reported, but late
       onset after treatment initiation and extensive subcortical
       topography is unusual and represents a diagnostic challenge.
       [/quote]
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