Abstract
A 41-year-old Japanese man with relapsing-remitting MS for 10 years presented with remittent fever over 38 °C and headache (Day 0). Prior to MS diagnosis, he had experienced double vision and reduced visual acuity of the right eye. Three years after these initial symptoms, he developed thoracic myelitis. Oligoclonal bands were positive, and serum anti-aquaporin-4 antibodies in cell based assay were negative. MS was diagnosed, and fingolimod treatment was started. The patient was stable for the next 6 years after fingolimod initiation and obtained a 2.0 score on the expanded disability status scale (EDSS). One year before fever and headache was reported, the median lymphocyte count was 384 (366–414) /µL. (figure e-1)
- Received July 27, 2020.
- Accepted November 4, 2020.
- © 2021 American Academy of Neurology
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