RT Journal Article SR Electronic T1 Tumefactive demyelination: an approach to diagnosis and management JF Journal of Neurology, Neurosurgery & Psychiatry JO J Neurol Neurosurg Psychiatry FD BMJ Publishing Group Ltd SP 1047 OP 1053 DO 10.1136/jnnp-2012-304498 VO 84 IS 9 A1 Todd A Hardy A1 Jeremy Chataway YR 2013 UL http://jnnp.bmj.com/content/84/9/1047.abstract AB Tumefactive lesions are an uncommon manifestation of demyelinating disease and can pose a diagnostic challenge in patients without a pre-existing diagnosis of multiple sclerosis. Choosing when to biopsy a tumefactive lesion to exclude alternative pathology can be difficult. Other questions include how best to treat an acute attack as well as the optimal timing of therapy to prevent relapse. This article aims to review the available literature for tumefactive demyelination and to propose an approach to diagnosis and management. We argue that disease modifying therapy should be considered for acute tumefactive demyelinating lesions only once criteria of dissemination in time and space are fulfilled and the diagnosis of multiple sclerosis is confirmed.