scholarly journals Determinants of disability development in patients with multiple sclerosis

2021 ◽  
Vol 79 (6) ◽  
pp. 489-496
Author(s):  
Fatma Kara ◽  
Mehmet Fatih Göl ◽  
Cavit Boz
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Age Of Onset ◽  
Neurological Diseases ◽  
First Episode ◽  
Clinical Parameters ◽  
Clinical Factors ◽  
Mcdonald Criteria ◽  
Kaplan Meier ◽  
The Central Nervous System

Abstract Background: Multiple sclerosis (MS) is one of the most common chronic neurological diseases affecting the central nervous system in young adults. Objective: To investigate demographic and clinical factors that are effective in the development of irreversible disability from the onset of MS, and to identify factors that affect the transformation from the relapse-remitting MS (RRMS) phase to the progressive MS (PMS) phase. Methods: Retrospective study on 741 patients who were diagnosed with RRMS and PMS according to the McDonald criteria, and were enrolled into the Turkish MS database of the Department of Neurology MS Polyclinic, at the Faculty of Medicine, Karadeniz Technical University, in Trabzon, Turkey. Kaplan-Meier analysis was used to evaluate the time taken to reach EDSS 4 and EDSS 6 from the onset of disease, and the time taken between EDSS 4 and EDSS 6. Results: Age of onset >40 years; having polysymptomatic-type onset, pyramidal or bladder-intestinal system-related first episode; ≥7 episodes in the first 5 years; and <2 years between the first two episodes were found to be effective for MS patients to reach EDSS 4 and EDSS 6. The demographic and clinical parameters that were effective for progression from EDSS 4 to EDSS 6 were: pyramidal or bladder-intestinal system-related first episode; 4‒6 episodes in the first 5 years; >2 years until start of first treatment; and smoking. Conclusions: Our findings reveal important characteristics of MS patients in our region. However, the associations between these parameters and MS pathophysiology remain to be elucidated.

scholarly journals Comparison of Seven Formulae and Isoelectrofocusing for Determination of Intrathecally Produced IgG in Neurological Diseases

1992 ◽  
Vol 29 (4) ◽  
pp. 405-410 ◽  
Author(s):  
Sten Öhman ◽  
Jan Ernerudh ◽  
Pia Forsberg ◽  
Annemarie Henriksson ◽  
Henning von Schenck ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Reference Group ◽  
Neurological Diseases ◽  
Diagnostic Sensitivity ◽  
Reference Limits ◽  
The Central Nervous System ◽  
Positive Results

Seven different formulae and agarose isoelectrofocusing (AIF) using immunolabelling for IgG were compared for their ability to discriminate between intrathecally produced IgG and transudated IgG in cerebrospinal fluid. All reference limits were set to a specificity of 97·5% (reference group, n = 211). The probability of a positive test ( p+) was evaluated for 112 patients with multiple sclerosis (MS), 42 with meningitis, 114 with noninflammatory diseases affecting the central nervous system (CNS), 23 with Guillain-Barré syndrome, and 56 with various diseases not affecting the CNS. Agarose isoelectrofocusing had the best diagnostic sensitivity (93%) for MS, combined with a low p+ (0–19%) for other diseases. Among the formulae, the IgG extended index and Reiber's hyperbolic formula were equivalent, giving high (75–79%) diagnostic sensitivity for MS combined with low p+ (4–22%) for other diseases. All other formulae, although sensitive for MS, had a higher rate of false positive results.

scholarly journals COMBINATION OF MULTIPLE SCLEROSIS AND HEREDITARY OPTICAL LEBER’S NEUROPATHY. CLINICAL CASE

2021 ◽  
Vol 30 (4) ◽  
pp. 50-54
Author(s):  
Azalia Aisarovna Sokolova ◽  
◽  
Leonid Sergeevich Zemlyanushin ◽  
Elvira Aysarovna Vashkulatova ◽  
Sofia Mikhailovna Zemlyanushina
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Genetic Testing ◽  
Optic Nerve ◽  
Clinical Case ◽  
Demyelinating Disease ◽  
Mcdonald Criteria ◽  
The Central Nervous System ◽  
Hereditary Optic Atrophy

The article discusses a clinical case of demyelinating disease of the central nervous system, multiple sclerosis in combination with Leber’s hereditary optic atrophy of the optic nerve (Harding syndrome). The debut of the disease at the age of 24 in the form of a simultaneous bilateral decrease in vision, with subsequent atrophy of the optic nerves in both eyes. The diagnosis of multiple sclerosis was confi rmed according to the 2017 McDonald criteria, the diagnosis of Leber’s disease was confi rmed by genetic testing. An important point in the diff erential diagnosis was the identifi cation of the G3460A mutation in the ND1 gene and intrathecal synthesis of oligoclonal immunoglobulin G.

Biopsy-Supported Tumefactive Demyelination of the Central Nervous System in Children

2016 ◽  
Vol 31 (14) ◽  
pp. 1528-1533 ◽  
Author(s):  
Seema Bangalore Hanumanthe ◽  
Carla Francisco ◽  
Janace Hart ◽  
Jennifer Graves ◽  
Emmanuelle Waubant
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Age Of Onset ◽  
Progressive Multiple Sclerosis ◽  
High Dose ◽  
Clinical Relapse ◽  
Oligoclonal Band ◽  
Mcdonald Criteria ◽  
Radiological Data

Pediatric tumefactive lesions remains challenging to clinicians in terms of diagnosis and treatment. The authors describe 11 children with biopsy-proven central nervous system tumefactive demyelination. The mean age of onset was 11 years. Clinical and radiological data coupled with biopsy aided in the diagnosis of tumefactive demyelination. Of the 6 cases in which oligoclonal band data were available, only 3 showed oligoclonal band in the cerebrospinal fluid. Due to poor recovery despite treatment with high-dose glucocorticosteroids, intravenous immunoglobulin, and/or plasmapheresis, 6 cases went on to receive cyclophosphamide with marked improvement. Long-term data were available on 9 cases. Eight of 9 cases were started on preventative multiple sclerosis therapy after initial presentation; 1 is pending discussion with family. Five of the 8 cases had clinical relapse during treatment. Seven cases met 2010 McDonald criteria for multiple sclerosis at follow-up, (1 developed secondary progressive multiple sclerosis), and 2 cases remained as clinically isolated syndrome on treatment.

scholarly journals COVID-19 Immunopathology and the Central Nervous System: Implication for Multiple Sclerosis and Other Autoimmune Diseases with Associated Demyelination

2020 ◽  
Vol 10 (6) ◽  
pp. 345 ◽  
Author(s):  
Marina Kleopatra Boziki ◽  
Alexios-Fotios A. Mentis ◽  
Maria Shumilina ◽  
Gleb Makshakov ◽  
Evgeniy Evdoshenko ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Neurological Diseases ◽  
Demyelinating Diseases ◽  
Relevant Implication ◽  
The Central Nervous System ◽  
Disease Modifying Treatment

In the frame of the coronavirus disease 2019 (COVID-19) pandemic, recent reports on SARS-CoV-2 potential neuroinvasion placed neurologists on increased alertness in order to assess early neurological manifestations and their potentially prognostic value for the COVID-19 disease. Moreover, the management of chronic neurological diseases, such as Multiple Sclerosis (MS), underwent guided modifications, such as an Extended Interval Dose (EID) of Disease-Modifying Treatment (DMT) administration, in order to minimize patients’ exposure to the health system, thus reducing the risk of SARS-CoV-2 infection. In this review, we summarize existing evidence of key immune pathways that the SARS-CoV-2 modifies during COVID-19 and the relevant implication for MS and other autoimmune diseases with associated demyelination (such as Systemic lupus erythematosus and Antiphospholipid syndrome), including the context of potential neuroinvasion by SARS-Cov-2 and the alterations that DMT induces to the immune system. Moreover we hereby aim to provide an overview of the possible consequences that COVID-19 may carry for the Central Nervous System (CNS) in People with MS (PwMS) and other demyelinating diseases, which are likely to pose challenges for treating Neurologists with respect to the long-term disease management of these diseases.

Mills' syndrome. A clinical case of a rare degenerative pathology of the central nervous system

2020 ◽  
pp. 57-60
Author(s):  
Konstantin Gulyabin
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Neurological Diseases ◽  
Cortical Atrophy ◽  
Primary Lateral Sclerosis ◽  
System A ◽  
The Central Nervous System ◽  
Primary Lateral ◽  
Lateral Sclerosis ◽  
Mills Syndrome

Mills' syndrome is a rare neurological disorder. Its nosological nature is currently not completely determined. Nevertheless, Mills' syndrome is considered to be a rare variant of the degenerative pathology of the central nervous system – a variant of focal cortical atrophy. The true prevalence of this pathology is unknown, since this condition is more often of a syndrome type, observed in the clinical picture of a number of neurological diseases (primary lateral sclerosis, frontotemporal dementia, etc.) and is less common in isolated form.

First Presentation of an Acquired Demyelinating Syndrome

2017 ◽  
Vol 16 (03) ◽  
pp. 164-170
Author(s):  
Rachel Gottlieb-Smith ◽  
Amy Waldman
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
The Central Nervous System

AbstractAcquired demyelinating syndromes (ADS) present with acute or subacute monofocal or polyfocal neurologic deficits localizing to the central nervous system. The clinical features of distinct ADS have been carefully characterized including optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis. These disorders may all be monophasic disorders. Alternatively, optic neuritis, partial transverse myelitis, and acute disseminated encephalomyelitis may be first presentations of a relapsing or polyphasic neuroinflammatory disorder, such as multiple sclerosis or neuromyelitis optica. The clinical features of these disorders and the differential diagnosis are discussed in this article.

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