Development of extensive brain lesions following fingolimod (FTY720) treatment in a patient with neuromyelitis optica spectrum disorder

Mult Scler. 2012 Jan;18(1):113-5. doi: 10.1177/1352458511431973. Epub 2011 Dec 6.


We report the case of a patient who developed extensive brain lesions during fingolimod (FTY720) treatment in the TRANSFORMS study. His initial diagnosis was multiple sclerosis, but after encephalopathy anti-aquaporin4 antibody (anti-AQP4 Ab) was detected, it was changed to neuromyelitis optica spectrum disorder. After treatment with fingolimod, he developed bilateral extensive brain lesions. The brain MRI showed lesions predominantly involving the right frontal and parietal lobes, with vasogenic edema and enhancement. He had residual encephalomalacia and no recurrence with steroid treatment over 3 years following withdrawal of fingolimod.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain / drug effects
  • Brain / pathology*
  • Fingolimod Hydrochloride
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Male
  • Neuromyelitis Optica / drug therapy*
  • Neuromyelitis Optica / pathology*
  • Propylene Glycols / adverse effects*
  • Sphingosine / adverse effects
  • Sphingosine / analogs & derivatives*


  • Immunosuppressive Agents
  • Propylene Glycols
  • Fingolimod Hydrochloride
  • Sphingosine