Miroslav Brozman, Slavomíra Kováčová, Monika Virágová, Marta Miklošková, Daša Viszlayová, Valéria Andelová, Blanka Pogranová
Authors refer the case of 48-year old woman with 15-years history of multiple sclerosis. The patient developed the progressive
multifocal leukoencephalopathy with massive right hemispheral damage after 29 natalizumab infusions. Following
the plasmapheresis treatment the typical immune reconstitution inflammatory syndrome has developed requiring
repeated massive corticosteroid therapy combined with mannitol administration. After 10 courses of intravenous
corticosteroid therapy the inflammatory syndrome has resolved. The authors document the evolution of this complication
by serial magnetic resonance imaging of the brain and cerebrospinal fluid findings. The patient could be discharged
home after 5 months of hospitalisation. She depends on daily care and rehabilitation because of severe left-sided
hemiparesis.