Although the association between TNF inhibitor exposure and inflammatory CNS events has been postulated from previous studies, inflammatory CNS events can occur without TNF inhibitor exposure, and reports exist predating the TNF inhibitor treatment era.15,16 Furthermore, inflammatory demyelinating CNS events may occur with a higher frequency in patients with autoimmune diseases as demonstrated by familial clusters and case-control disease studies.17,18,19. Here, TNF is linked to autoimmune disease.