Reappraisal of CSF-specific oligoclonal bands in Asia

Multiple Sclerosis Journal ◽

10.1177/13524585211048752 ◽

2021 ◽

pp. 135245852110487

Author(s):

Ki Hoon Kim ◽

Su-Hyun Kim ◽

Na Young Park ◽

Jae-Won Hyun ◽

Ho Jin Kim

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Demyelinating Diseases ◽

Oligoclonal Bands ◽

Asian People

The prevalence of cerebrospinal fluid–specific oligoclonal bands (CSF-OCBs) was reported to be low in Asian people with multiple sclerosis (pwMS) compared to that in Western pwMS. It is yet to be determined whether it is a genuine feature of Asian pwMS or a misapprehension owing to past mis-classification of MS-mimicking diseases as MS. We aimed to reappraise the prevalence of CSF-OCBs in Korean pwMS after carefully excluding other central nervous system-inflammatory demyelinating diseases since 2017. Among 88 subjects, 78 (88.6%) were positive for CSF-OCBs, which suggests the prevalence of CSF-OCBs is not different between Korean and Western pwMS.

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Disappearance of cerebrospinal fluid oligoclonal bands after natalizumab treatment of multiple sclerosis patients

Multiple Sclerosis Journal ◽

10.1177/1352458511428465 ◽

2011 ◽

Vol 18 (7) ◽

pp. 1038-1041 ◽

Cited By ~ 35

Author(s):

Felipe von Glehn ◽

Alessandro S Farias ◽

Augusto C Penalva de Oliveira ◽

Alfredo Damasceno ◽

Ana Leda F Longhini ◽

...

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Oligoclonal Bands ◽

Natalizumab Treatment ◽

The Central Nervous System ◽

Immunologic Abnormality ◽

Csf Oligoclonal Bands ◽

Multiple Sclerosis Patients

Intrathecal immunoglobulin synthesis in an oligoclonal pattern is the most common immunologic abnormality detected in MS patients. Various treatments, such as immunomodulators and immunosuppressors, have not been found to modify it. Natalizumab hinders migration of encephalitogenic T-cells into the central nervous system (CNS), reducing inflammatory response. Its impact on CSF oligoclonal bands (OCBs) has not been demonstrated. This report describes its effect in four out of six patients with multiple sclerosis after a mean of 10 infusions: the CSF was negative for OCBs at the second lumbar puncture. In conclusion, natalizumab treatment can reduce CSF OCBs to undetectable levels, although the clinical significance of this observation is not yet known.

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Pediatric Inflammatory and Autoimmune Neurologic Disorders at a Tertiary Medical Center

Journal of Child Neurology ◽

10.1177/0883073820941751 ◽

2020 ◽

Vol 35 (14) ◽

pp. 949-952

Author(s):

Angela M. Curcio ◽

Jennifer M. Bain ◽

Erin S. Beck ◽

Wendy S. Vargas

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Cerebellar Ataxia ◽

Oligoclonal Bands ◽

Not Otherwise Specified ◽

Nmdar Encephalitis ◽

Acute Cerebellar Ataxia ◽

Acute Demyelinating Encephalomyelitis

Objectives: To describe the spectrum of pediatric inflammatory neurologic diseases and compare the sensitivity of ancillary testing for these diagnoses. Methods: We analyzed clinical features and outcomes of 98 children with an immune-mediated central nervous system disorder. We compared sensitivities of each diagnostic modality. Results: We identified the following diagnoses: acute cerebellar ataxia (n = 14; 14.3%), acute demyelinating encephalomyelitis (n = 13; 13.3%), multiple sclerosis (MS) (n = 18; 18.4%), anti- N-methyl-d-aspartate receptor encephalitis (anti-NMDAR encephalitis) (n = 15; 15.3%), encephalitis not otherwise specified (n = 12; 12.2%), and “Other” (n = 26; 26.5%). “Other” included acute transverse myelitis, neuromyelitis optica, central nervous system lupus, primary central nervous system vasculitis, Rasmussen encephalitis, opsoclonus myoclonus ataxia syndrome, and clinically isolated syndrome. The mean age of onset of all diagnoses was 7.9 ± 5.5 years. The diagnostic sensitivity of magnetic resonance imaging (MRI) for acute demyelinating encephalomyelitis and multiple sclerosis was 92.3% and 94.4%, respectively. Cerebrospinal fluid was sensitive for multiple sclerosis in 92.3%, where 75% of patients had cerebrospinal fluid oligoclonal bands. Electroencephalogram (EEG) coupled with cerebrospinal fluid studies was highly sensitive for anti-NMDAR encephalitis (100%). EEG was sensitive for acute demyelinating encephalomyelitis and encephalitis not otherwise specified (77.8% and 80%). No diagnostic studies were sensitive for acute cerebellar ataxia. Seventy-three percent of patients with multiple sclerosis had residual deficits. Thirty-six percent of anti-NMDAR encephalitis patients were nonverbal and wheel-chair bound. Conclusions: We found that MRI is useful for detecting multiple sclerosis and acute demyelinating encephalomyelitis, cerebrospinal fluid is helpful in diagnosing multiple sclerosis and anti-NMDAR encephalitis, and EEG is often abnormal in suspected anti-NMDAR encephalitis, acute demyelinating encephalomyelitis, and encephalitis not otherwise specified. Neurologic outcome at follow-up was unfavorable in patients with multiple sclerosis and anti-NMDAR encephalitis.

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Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130151 ◽

2013 ◽

Vol 71 (9B) ◽

pp. 685-688 ◽

Cited By ~ 4

Author(s):

Sandro Luiz de Andrade Matas ◽

Felipe von Glehn ◽

Gustavo Bruniera Peres Fernandes ◽

Carlos Augusto Senne Soares

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Acute Disseminated Encephalomyelitis ◽

Demyelinating Diseases ◽

Cerebrospinal Fluid Analysis ◽

Inflammatory Lesions ◽

Fluid Analysis ◽

The Central Nervous System

The central nervous system demyelinating diseases are a group of disorders with different etiologies, characterized by inflammatory lesions that are associated with loss of myelin and eventually axonal damage. In this group the most studied ones are multiple sclerosis (MS), neuromyelitis optic (NMO) and acute disseminated encephalomyelitis (ADEM). The cerebrospinal fluid is essential to differentiate between these different syndromes and to define multiple sclerosis, helping to assess the probability of Clinical Isolated Syndrome turn into multiple sclerosis.

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Multiple Sclerosis and Other Inflammatory Demyelinating Diseases of the Central Nervous System

Neurology in Clinical Practice ◽

10.1016/b978-1-4377-0434-1.00079-7 ◽

2012 ◽

pp. 1283-1313 ◽

Cited By ~ 4

Author(s):

Maria K. Houtchens ◽

Fred D. Lublin ◽

Aaron E. Miller ◽

Samia J. Khoury

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Nervous System ◽

Demyelinating Diseases ◽

The Central Nervous System

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Demyelinating disorders of the central nervous system

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.0241002_update_001 ◽

2010 ◽

pp. 4948-4963

Author(s):

Siddharthan Chandran ◽

Alastair Compston

Keyword(s):

Multiple Sclerosis ◽

Central Nervous System ◽

Nervous System ◽

Acute Disseminated Encephalomyelitis ◽

Demyelinating Diseases ◽

Demyelinating Disorder ◽

System P ◽

The Central Nervous System ◽

Demyelinating Disorders ◽

Brain And Spinal Cord

Clinicians suspect demyelination when episodes reflecting damage to white matter tracts within the central nervous system occur in young adults. The paucity of specific biological markers of discrete demyelinating syndromes places an emphasis on clinical phenotype—temporal and spatial patterns—when classifying demyelinating disorders. The diagnosis of multiple sclerosis, the most common demyelinating disorder, becomes probable when these symptoms and signs recur, involving different parts of the brain and spinal cord. Other important demyelinating diseases include post-infectious neurological disorders (acute disseminated encephalomyelitis), demyelination resulting from metabolic derangements (central pontine myelinosis), and inherited leucodystrophies that may present in children or in adults. Accepting differences in mechanism, presentation, and treatment, two observations can usefully be made when classifying demyelinating disorders. These are the presence or absence of inflammation, and the extent of focal vs. diffuse demyelination. Multiple sclerosis is prototypic for the former, whereas dysmyelinating disorders, such as leucodystrophies are representative of the latter....

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Balò’s concentric sclerosis in a case of cocaine-levamisole abuse

SAGE Open Medical Case Reports ◽

10.1177/2050313x20940532 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2094053 ◽

Cited By ~ 1

Author(s):

Daniela Grasso ◽

Carmela Borreggine ◽

Giulia Castorani ◽

Doriana Vergara ◽

Lucia Maria Cecilia Dimitri ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Central Nervous System ◽

Nervous System ◽

Cocaine Abuse ◽

Hemorrhagic Stroke ◽

Demyelinating Diseases ◽

Resonance Imaging ◽

Radiological Findings ◽

Baló’S Concentric Sclerosis

Baló’s concentric sclerosis is a rare variant of multiple sclerosis. It belongs to the group of primary inflammatory central nervous system demyelinating diseases having no clear etiology. Peculiar radiological findings on magnetic resonance imaging are alternating rings of demyelinated and myelinated axons resembling an “onion bulb.” We report on a case of a patient with cocaine abuse who presented with Balò’s-like acute multifocal leukoencephalopathy supported by histological and radiological findings. The abuse of cocaine and its most frequent adulterant, levamisole, may induce ischemic or hemorrhagic stroke and metabolic or multifocal inflammatory leukoencephalopathy. Only a few studies described levamisole-induced leukoencephalopathy mimicking Balò round lesions. Nevertheless, it has not yet been established the correlation between them; it might also be possible that the cocaine/levamisole addiction represents just a coincidence in some of those patients affected by Balò sclerosis disease.

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