Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Brain biopsies of multiple sclerosis patients identified three intraindividually stable lesion patterns. Apart from beneficial effects of plasma exchange in patients with type <jats:styled-content style="fixed-case">II</jats:styled-content> lesions, little is known about how multiple sclerosis lesion histology could guide therapeutic decisions.</jats:p></jats:sec><jats:sec><jats:title>Case presentation</jats:title><jats:p>Here, we report on a 53‐year‐old male patient with polysymptomatic cerebral syndrome as the first episode of multiple sclerosis. Brain biopsy showed an inflammatory demyelinating lesion with apoptotic oligodendrocytes and a loss of myelin‐associated glycoprotein, pathological features typical for pattern <jats:styled-content style="fixed-case">III</jats:styled-content> lesions. High‐dose steroids and immunosuppressive treatment with mitoxantrone led to a substantial improvement of disability and long‐term clinical stability.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Mitoxantrone therapy along with steroid pulses could potentially be considered as a therapeutic option for pattern <jats:styled-content style="fixed-case">III</jats:styled-content> lesions.</jats:p></jats:sec>