A rare presentation of multiple sclerosis: Schilder's disease

Abstract

Schilder's disease is a rare form of multiple sclerosis. It concerns mostly teenagers and young adults. The Clinical signs and symptoms might be atypical for early multiple sclerosis which often mimics intracranial neoplasm or abscess. Their coursemay be either progressive or relapsing and remitting, with a high sensitivity to steroids. The knowledge of this rare form ofmultiple sclerosis may help radiologists in assessing a precise diagnosis. We report the case of a young 22-year-old patientadmitted to the emergency room with an array of headache, vomiting and frontal syndrome. Magnetic resonance imaging shows2 bilateral demyelinating frontal areas. The patient was put under corticosteroids bolus with discreet improvement in her clinicalcondition. After 6 months of follow-up, we did not notice any real clinical improvement. Although Schilder's disease isconsidered to be a variant of Multiple Sclerosis, its clinical and imaging features behaves more like a demyelinating conditionwith its monophasic course with, however, serious clinical consequences if the treatment is delayed.

Keywords

• Schilder's disease
• Multiple sclerosis
• MRI
• Demyelinating