Marburg's variant multiple sclerosis

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Marburg's variant of multiple sclerosis, also known as Marburg multiple sclerosis or acute fulminant multiple sclerosis, is considered one of the multiple sclerosis borderline diseases, which is a collection of diseases classified by some as MS variants and by others as different diseases. Other diseases in this group are Neuromyelitis optica (NMO), Balo concentric sclerosis, and Schilder's disease.[1] The graver course is one form of malignant multiple sclerosis, with patients who reaching a significant level of disability in less than 5 years from their first symptoms, often in a matter of months.[2]

It took its name from Otto Marburg. It can be diagnosed in vivo with an MRI scan.[3] If Marburg Disease occurs in the form of a single large lesion, it can be radialogically indistinguishable from a brain tumor or abscess. In such cases, craniotomy and biopsy is needed to exclude other pathologies.[4] It is usually lethal, but it has been found to be responsive to Mitoxantrone[5] and Alemtuzumab,[6] and it has also been responsive to autologous stem cell transplantation.[7] Recently it has been shown that it presents a heterogeneous response to medication, as does standard MS.[8]

Currently, Marburg MS is considered a synonym for Tumefactive MS.[9]

Prognosis[edit]

Marburg varient of MS is an acute fulminant demyelinating process which in most cases progresses inexorably to death within 1–2 years.[10] However, threre are some reports of Marburg MS reaching stability by 3 years and hence there is some possibily of lng survival and clinical stability in such patients.[11]

References[edit]

  1. ^ Fontaine B (2001). "Borderline forms of multiple sclerosis". Rev. Neurol. (Paris) (in French) 157 (8–9 Pt 2): 929–34. PMID 11787357. 
  2. ^ Lublin FD, Reingold SC (April 1996). "Defining the clinical course of multiple sclerosis: Results of an international survey". Neurology 46 (4): 907–11. doi:10.1212/WNL.46.4.907. PMID 8780061. 
  3. ^ Capello E, Mancardi GL (November 2004). "Marburg type and Balò's concentric sclerosis: rare and acute variants of multiple sclerosis". Neurol. Sci. 25 (Suppl): S361–3. doi:10.1007/s10072-004-0341-1. PMID 15727234. 
  4. ^ Walid MS, Sanoufa M (2010). "The diagnosis of Marburg Disease is course-dependent". GMS Ger Med Sci. 
  5. ^ Jeffery DR, Lefkowitz DS, Crittenden JP (January 2004). "Treatment of Marburg variant multiple sclerosis with mitoxantrone". J Neuroimaging 14 (1): 58–62. doi:10.1111/j.1552-6569.2004.tb00217.x. PMID 14748210. 
  6. ^ Gormley KM, Zajicek JP (2006). "Alemtuzumab and craniotomy for severe acute demyelinating illness". 16th Meeting of the European Neurological Society. 
  7. ^ Kimiskidis VK, Sakellari I, Tsimourtou V, et al. (2007). "Autologous stem-cell transplantation in malignant multiple sclerosis: a case with a favorable long-term outcome". Multiple Sclerosis 14 (2): 278–83. doi:10.1177/1352458507082604. PMID 17942513. 
  8. ^ Leussink VI, Lehmann HC, Meyer Zu Hörste G, Hartung HP, Stüve O, Kieseier BC. (2008). "Rituximab induces clinical stabilization in a patient with fulminant multiple sclerosis not responding to natalizumab: Evidence for disease heterogeneity". Journal of Neurology 255 (9): 1436–8. doi:10.1007/s00415-008-0956-x. PMID 18685916. 
  9. ^ See explanation at
  10. ^ Dan L. Longo, et.al, ed. (2012). Harrison's principles of internal medicine. (18th ed.). New York: McGraw-Hill. p. 3407. ISBN 9780071748896. 
  11. ^ Turatti, M; Gajofatto, A; Rossi, F; Vedovello, M; Benedetti, MD (Dec 2010). "Long survival and clinical stability in Marburg's variant multiple sclerosis.". Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 31 (6): 807–11. doi:10.1007/s10072-010-0287-4. PMID 20461429. 

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