Clinical course in multiple sclerosis patients presenting with a history of progressive disease

2014 ◽  
Vol 3 (1) ◽  
pp. 67-71 ◽  
Author(s):  
K.S. Pandey ◽  
S.C. Krieger ◽  
C. Farrell ◽  
C. Hannigan ◽  
T. DeAngelis ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Disease ◽  
Clinical Course ◽  
History Of ◽  
Multiple Sclerosis Patients

scholarly journals Pain syndrome patterns and their characteristics in multiple sclerosis patients

2021 ◽  
Vol 27 (1-2) ◽  
pp. 36-45
Author(s):  
M.I. Bozhenko ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Pain Syndrome ◽  
Persistent Pain ◽  
Pain Syndromes ◽  
Constant Pain ◽  
Average Pain ◽  
History Of ◽  
Multiple Sclerosis Patients ◽  
Syndrome Patterns ◽  
Paroxysmal Pain

Aim of the research is to analyze the patterns of pain syndromes and their characteristics in multiple sclerosis patients. Materials and Methods. A total of 104 multiple sclerosis patients complaining of pain during the last month were examined in Lviv Regional Multiple Sclerosis Center. We analyzed medical records, performed general medical and neurological examinations and compiled history of lifestyle, illness and pain. The VAS and PainDetect questionnaires were used to assess the characteristics of pain syndromes. The patients were asked to choose one of the 4 typical patterns of pain, which best described their feelings. Then the analysis of pain syndrome patterns and their characteristics was carried out. Results and Discussions. All 4 typical patterns of pain syndromes were registered in multiple sclerosis patients. However, only 26.92% of the participants experienced an intermittent pain pattern. The rest of patients suffered from patterns characterized by persistent pain. The evaluation of the patterns and their characteristics revealed typical features. The highest intensity of the severest and average pain during the last month was present in the patients suffering from constant pain with distinct attacks: 8.0 [7.0; 9.0] points (p<0.05) and 7.0 [5.0; 8.0] points (p<0.05), respectively. Persistent paroxysmal pain was more common in the multiple sclerosis patients with neuropathic pain (43.8±8.8% vs 20.4±5.8%, p<0.05). Irradiating pain is also characteristic to this pattern in 52.9±8.6% of patients (p<0.05). The head is the most common pain localization in the patients experiencing persistent pain with severe attacks - 82.4±9.2% of cases (p<0.05). Conclusions. Pain is a permanent symptom in a significant number of multiple sclerosis patients. It can have different patterns of progression. However, it has typical characteristics and their understanding will aid in the diagnosis, prognosis and treatment of pain syndromes in multiple sclerosis patients

Development of cladribine treatment in multiple sclerosis

1996 ◽  
Vol 1 (6) ◽  
pp. 343-347 ◽  
Author(s):  
JC Sipe ◽  
JS Romine ◽  
JA Koziol ◽  
R McMillan ◽  
J Zyroff ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Course ◽  
Progressive Multiple Sclerosis ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Relapsing Remitting ◽  
History Of ◽  
New Type ◽  
Cns Demyelination

Cladribine is a new type of drug with properties of selective lymphocyte suppression that appear to favorably alter the clinical course of progressive multiple sclerosis (MS). The history of the development of cladribine treatment in chronic progressive MS is discussed, and the application of cladribine treatment to progressive multiple sclerosis in a double-blind, placebo crossover study is reviewed. Cladribine selectively targets both resting and dividing lymphocytes and may be able to destroy the activated lymphocytes that induce CNS demyelination, thus producing stabilization or improvement in chronic MS. Although the role of cladribine has not yet been fully defined, additional studies are underway to evaluate the efficacy and safety of cladribine in both progressive MS and relapsing-remitting MS.

Temporal and Clinical Course of Multiple Sclerosis

2016 ◽  
Author(s):  
Erica Grazioli ◽  
Channa Kolb ◽  
Bianca Weinstock-Guttman
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Characteristics ◽  
Progressive Disease ◽  
Clinical Course ◽  
Disease Classification ◽  
Clinical Relapse ◽  
Resonance Imaging ◽  
Genetic Biomarkers ◽  
Active Disease ◽  
Over Time

The temporal and clinical course of multiple sclerosis is heterogeneous, varying among patients as well as over time in the same individual. Greater specificity in describing disease classification and course is important for conduct of clinical trials as well as prognosis for individual patients. This chapter reviews the results of recent consensus panels that have further defined the relapsing and progressive forms of multiple sclerosis through clarification of clinical relapse, subclinical relapse, active disease, and progressive disease. Clinical characteristics, conventional and nonconventional magnetic resonance imaging metrics, and immunologic and genetic biomarkers that can be used to predict disease severity and course are also discussed.

Pupillary response to sparse multifocal stimuli in multiple sclerosis patients

2013 ◽  
Vol 20 (7) ◽  
pp. 854-861 ◽  
Author(s):  
EN Ali ◽  
T Maddess ◽  
AC James ◽  
C Voicu ◽  
CJ Lueck
Keyword(s):  
Multiple Sclerosis ◽  
Pupillary Response ◽  
Time To Peak ◽  
Relapsing Remitting ◽  
Percentage Area ◽  
History Of ◽  
Diagnostic Power ◽  
Multiple Sclerosis Patients ◽  
A Prospective Study ◽  
Delayed Time

Objectives: The objective of this paper is to investigate the pattern of abnormalities and establish the diagnostic power of multifocal objective pupil perimetry (mfPOP) in multiple sclerosis (MS). Methods: A prospective study enrolling 35 normal (47.9 ± 16.8 years, 22 females) and 85 MS subjects (49.8 ± 11.3 years, 62 females; 72 relapsing–remitting (RR), and 13 primary or secondary progressives (PorS)). EDSS scores for the RR and PorS groups were 3.53 ± 1.04 (mean ± SD), and 5.9 ± 1.43, respectively. mfPOP responses were obtained from 44 regions/visual field. Each region was analysed according to response time-to-peak and standardised amplitude (AmpStd). Predictive power was measured by percentage area under the receiver operator curve (%AUC). Results: mfPOP responses showed a significant reduction of 0.69 ± 0.04 dB (mean ± SE) in AmpStd and significantly delayed time-to-peak of 25.95 ± 0.89 ms (mean ± SE) in MS subjects compared to control subjects ( p<0.001). %AUC was greater for time-to-peak than AmpStd both for RR and PorS patients. Diagnostic power followed the EDSS scores but not a history of optic neuritis. Conclusions: mfPOP is well tolerated and potentially has a role in the diagnosis and assessment of patients with MS.

scholarly journals Dynamics of quality of life indicators at a multiple sclerosis

2010 ◽  
Vol 9 (4) ◽  
pp. 63-69
Author(s):  
V. N. Karnaukh ◽  
Yu. A. Lugovtsova ◽  
I. A. Barabash
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Clinical Course ◽  
Life Quality ◽  
Immunomodulatory Therapy ◽  
Quality Factors ◽  
Quality Of Life Indicators ◽  
Sf 36 ◽  
Multiple Sclerosis Patients

The study explored the life quality of 94 multiple sclerosis patients in comparison to healthy respondents and in dependence to different parameters of the disease with the use of SF-36 questionnaire. The study has discovered a decline of all the factors of life quality and their dependence on disablement intensity, clinical course and duration of the disease. Immunomodulatory therapy contributed to the improvement of life quality factors.

scholarly journals Ishihara's Tests for Color Blindness: A useful Indicator of Visual Involvement in Multiple Sclerosis

2000 ◽  
Vol 2 (1) ◽  
pp. 6-13
Author(s):  
MD Kaufman ◽  
DM Lutz ◽  
J Norton
Keyword(s):  
Multiple Sclerosis ◽  
Evoked Potentials ◽  
Visual Evoked Potentials ◽  
Cost Effective ◽  
Color Blindness ◽  
Bedside Test ◽  
History Of ◽  
Multiple Sclerosis Patients ◽  
Effective Adjunct ◽  
Visual Evoked

Abstract Because vision commonly is affected in persons with multiple sclerosis, it would be helpful to have a bedside test capable of identifying abnormalities that are not readily apparent. This study evaluated the sensitivity and specificity of the first 11 plates of Ishihara's Tests for color blindness (1995 concise edition) as compared to visual evoked potentials in patients with multiple sclerosis reporting normal vision. Forty-five multiple sclerosis patients and 42 controls, aged 25 to 44 years, were assessed. After examination of vision by a neurologist, Ishihara's Tests for color blindness and visual evoked potential tests were administered under conditions similar to those encountered in a neurologic practice. The specificity for each test was defined by the responses of the control population. In differentiating individuals with multiple sclerosis from controls, Ishihara's Tests for color blindness was as sensitive (62%; 28/45) and specific (100%; 42/42) as visual evoked potentials (sensitivity = 58%, 26/45; specificity = 98%, 41/42). Ishihara's Tests for color blindness identified a different population of patients and probably measured a different aspect of visual function than did visual evoked potentials. Ishihara's Tests for color blindness appeared more likely to identify patients with a long disease duration, while visual evoked potentials better identified patients with a history of optic neuritis. Ishihara's Tests for color blindness may be a simple and cost-effective adjunct for detecting and following the visual abnormalities of patients with multiple sclerosis.

scholarly journals Correlation of optic neuritis and retinal nerve fibre thickness using optical coherence tomography in a cohort of multiple sclerosis patients

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Izanne Roos ◽  
Rajeshree Budhoo ◽  
Linda Visser ◽  
Ahmed I. Bhigjee
Keyword(s):  
Multiple Sclerosis ◽  
Optical Coherence Tomography ◽  
Optic Neuritis ◽  
Nerve Fibre ◽  
Optical Coherence ◽  
Macular Volume ◽  
Rnfl Thickness ◽  
Significant Difference ◽  
History Of ◽  
Multiple Sclerosis Patients

Background: Optical coherence tomography (OCT) is a fast, non-invasive imaging technology that produces 3D, high-resolution images of the retina. Direct visualisation of the retina allows a unique opportunity to study the effects of multiple sclerosis (MS)-associated neurodegeneration on retinal ganglion cells as well as effects of retrobulbar demyelination on axonal and retinal architecture through measurement of retinal nerve fibre layer (RNFL) thickness and total macular volume (TMV). These findings are clinically important as axonal loss is irreversible and correlates with disability.Aim: To determine the role and usefulness of OCT in a local cohort of MS patients.Setting: Neurology Clinic, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa.Methods: Nineteen patients with MS currently being treated with interferon β-1b underwent OCT examination of both eyes. RNFL thickness and macular volume were measured and correlated with clinical disease characteristics, history of optic neuritis and level of disability.Results: Mean RNFL thickness was 77.3 μm with no significant difference in mean RNFL in eyes with a history of optic neuritis (ON) and those without (p = 0.4). Eyes with a history of ON did, however, have significantly thinner RNFL compared with the contralateral eye (p = 0.04). Despite a strong correlation between TMV and RNFL (p = 0.001), a subset of patients with normal RNFL had TMV that was less than 1% of what was expected. There was no correlation between RNFL and disability scores.Conclusion: OCT enables a direct axonal ‘optical biopsy’, for monitoring disease progression and treatment response in MS. RNFL thinning occurs independently of a history of optic neuritis and may represent a chronic optic neuropathy in patients with MS.Keywords: Multiple sclerosis; optical coherence tomography

scholarly journals Comparison of Visual Field Parameters in Early and Advanced Stages of Multiple Sclerosis Patients Without a History of Optic Neuritis

2013 ◽  
Vol 37 (2) ◽  
pp. 58-62 ◽  
Author(s):  
Mete Güler ◽  
Peykan Türkçüoğlu ◽  
Turgut Yılmaz ◽  
Tahir Kurtuluş Yoldaş ◽  
Roomasa Channa
Keyword(s):  
Multiple Sclerosis ◽  
Visual Field ◽  
Optic Neuritis ◽  
History Of ◽  
Advanced Stages ◽  
Multiple Sclerosis Patients

Contrast-enhanced magnetic resonance activity in relapsing remitting multiple sclerosis patients: a short term natural history study

2000 ◽  
Vol 6 (1) ◽  
pp. 43-49 ◽  
Author(s):  
F Bagnato ◽  
A Tancredi ◽  
N Richert ◽  
C Gasperini ◽  
S Bastianello ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Natural History ◽  
Initial Examination ◽  
Short Baseline ◽  
Relapsing Remitting ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Multiple Sclerosis Patients ◽  
The Relationship

Magnetic resonance imaging (MRI) has been used to study the history of multiple sclerosis (MS). We analyze the relationship between MRI activity in the first scan compared to the subsequent five scans, and we evaluate whether a shorter observation period of 3 months may predict the subsequent 3 months. Monthly enhanced MRI was performed in 103 relapsing remitting (RR) MS patients for 6 months. Thirty-five per cent of patients had an inactive scan on the initial examination. More than 80% of them developed MRI activity during the following 5 months. Eighteen per cent of patients had three consecutive inactive scans; 65% of them had at least one active scan on the subsequent 3 monthly MRI's. The relationship between the first scan and all subsequent scans demonstrates a clear weakening over time. Eighty-two per cent of patients had at least one active scan during the initial 3 consecutive months, the chance of becoming inactive decreased from 23% to 0% over the subsequent 3 months, according with the mean number of enhancing lesions during the first 3 months. These results suggest that neither a single scan nor a short baseline of 3 months may adequately describe the natural history of disease in an individual RRMS patient.

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