Multiple Sclerosis Relapsing Remitting Progressive Type

Author(s):  
Nora Fitri ◽  
Basjiruddin Ahmad ◽  
Yuliarni Syafrita

Multiple sclerosis (MS) is the most common neurologic demyelinating disease in high-income countries. The causes of MS is multifactorial involve genetics and the environment in which immune cell infiltration occurs across the blood-brain barrier, causing inflammation, demyelination, gliosis, and neuroaxonal degeneration in the substantia grisea in the central nervous system. A 23-year-old female patient was treated with four limbs weakened since 2 weeks ago accompanied by blurred vision, pain, cramps and stiffness in the back muscles and legs. The patient has experienced the same complaint before. Clinical findings reveal lhermitte sign, atrophy papillae, and tetraparese. On thoracic vertebral MRI examination without contrast and brain MRI with contrast obtained multiple sclerosis lesions. Patients receive steroid and antidepressant therapy. MS needs to be studied further because this number of cases began to emerge. 

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199957
Author(s):  
Fernando Labella ◽  
Fernando Acebrón ◽  
María del Carmen Blanco-Valero ◽  
Alba Rodrígez-Martín ◽  
Ángela Monterde Ortega ◽  
...  

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system whose etiology remains unclear. It has been suggested that MS can be triggered by certain viruses; however, human immunodeficiency virus (HIV) infection is associated with reduced incidence of MS. We present the case of a young patient diagnosed with active relapsing-remitting MS whose clinical course substantially improved following HIV infection and treatment. The patient achieved no evidence of disease activity status without any disease-modifying drugs. Both HIV-induced immunosuppression and antiretroviral therapy may have attenuated the clinical course in this patient.


Author(s):  
M Hoseinipourasl ◽  
M Zandkarimi ◽  
J Abdolmohammadi ◽  
K Sharifi ◽  
S Miraki

Background: Multiple sclerosis (MS) is a chronic, typically progressive and most common autoimmune disease which damaged the central nervous system. According to the reports in 2008, this disorder has affected 2 and 2.5 million people globally. While the reason is not clear, proposed causes for this include immunologic, environmental, infectious and genetic factors, and sexuality. MS can cause many symptoms, including blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, blindness, and more. There are four distinguished illness fields in MS: relapsing-remitting MS (RRMS), primary–progressive MS (PPMS), secondary–progressive MS (SPMS), and progressive–relapsing. MRI is a great tool to identify the asymptomatic distribution of lesions in space and time.Materials and Methods: 32 patients with MS plaques were evaluated by FLAIR and DWI pre- and post-Gadolinium injection compared with 15minutes delay T1w SE.Results: FLAIR post-inject had significantly better detection of the number and signal intensity of active MS lesions. DWI and ADC images detected active plaques different from non-active lesions without contrast.Conclusion: The result of this study showed that FLAIR post-inject had the highest sensitivity in detection of active MS lesions due to the CSF signal suppression in FLAIR, thus offering enough TR time recovery in active enhanced plaques.


2002 ◽  
Vol 8 (5) ◽  
pp. 390-395 ◽  
Author(s):  
E M Martínez-Cáceres ◽  
C Espejo ◽  
L Brieva ◽  
I Pericot ◽  
M Tintoré ◽  
...  

Chemokines and their receptors are important in the trafficking of peripheral leukocytes into the central nervous system, a major event in the pathogenesis of multiple sclerosis (MS). Evidence based on clinical, pathological and magnetic resonance imaging grounds supports some divergence between forms of MS with relapses [relapsing-remitting (RR) and secondary progressive (SP)] and the primary progressive (PP) form. To elucidate whether different pathogenic mechanisms are involved in PPMS, we compared membrane expression of a group of CC and CXC chemokine receptors (CCR1, CCR5, CXCR3, CXCR4) in peripheral blood of 68 MS patients (25 PPMS, 23 SPMS and 20 RRMS) and 26 healthy controls. We found a significant increase in surface expression of CCR5 in CD4+, CD8+, CD19+ and CD14+ cells as well as an increased percentage of CXCR3 and CXCR4 in CD14+ cells in MS patients compared to controls. Increased levels of CXCL10 (IP-10) and CCL5 (RANTES) in cerebrospinal fluid were also observed in a subgroup of MS patients. These results support that chemokines and their receptors are involved in the pathogenesis of MS. However, a pattern of chemokine-chemokine receptor expression characteristic of each clinical form of the disease failed to be observed.


2018 ◽  
pp. 1-8
Author(s):  
Aaron E. Miller ◽  
Tracy M. DeAngelis ◽  
Michelle Fabian ◽  
Ilana Katz Sand

Multiple sclerosis (MS), an inflammatory demyelinating disease of the central nervous system, typically affects young to middle-aged adults. Women are affected nearly three times as often as men. The diagnosis requires the demonstration of dissemination in space (DIS) and time (DIT) in a patient with no better clinical explanation. Evidence for either DIS or DIT or both may now be obtained from MRI, in addition to clinical manifestations. The most widely used diagnostic criteria are known as the McDonald criteria, and have been revised several times, most recently in 2017. In the current criteria, DIS may be achieved by the demonstration of at least one lesion in at least two different locations: periventricular, cortical/juxtacortical, infratentorial, or spinal cord. DIT may be considered in an initial magnetic resonance imaging (MRI) if there are simultaneously at least one gadolinium-enhancing lesion and one non-enhancing T2 hyperintense lesion; or alternatively, by the demonstration of a new lesion on any MRI subsequent to the first. The course of MS is characterized as relapsing-remitting (RRMS), secondary progressive, or primary progressive. Many effective disease-modifying agents are available for RRMS, but progressive forms have been much less successfully treated.


2019 ◽  
Vol 28 (12) ◽  
pp. 1507-1527 ◽  
Author(s):  
Giovanni Schepici ◽  
Serena Silvestro ◽  
Placido Bramanti ◽  
Emanuela Mazzon

Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating, and degenerative disease that affects the central nervous system. A recent study showed that interaction between the immune system and the gut microbiota plays a crucial role in the development of MS. This review reports the clinical studies carried out in recent years that aimed to evaluate the composition of the microbiota in patients with relapsing–remitting MS (RR-MS). We also report what is available in the literature regarding the effectiveness of fecal microbiota transplantation and the role of the diet in restoring the intestinal bacterial population. Studies report that patients with RR-MS have a microbiota that, compared with healthy controls, has higher amounts of Pedobacteria, Flavobacterium, Pseudomonas, Mycoplana, Acinetobacter, Eggerthella, Dorea, Blautia, Streptococcus and Akkermansia. In contrast, MS patients have a microbiota with impoverished microbial populations of Prevotella, Bacteroides, Parabacteroides, Haemophilus, Sutterella, Adlercreutzia, Coprobacillus, Lactobacillus, Clostridium, Anaerostipes and Faecalibacterium. In conclusion, the restoration of the microbial population in patients with RR-MS appears to reduce inflammatory events and the reactivation of the immune system.


2004 ◽  
Vol 10 (2) ◽  
pp. 145-148 ◽  
Author(s):  
John D Kriesel ◽  
Andrea White ◽  
Frederick G Hayden ◽  
S L Spruance ◽  
Jack Petajan

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system, which often follows a relapsing-remitting (RR) course with discrete attacks. MS attacks have been associated with upper respiratory infections (URIs), but the specific viruses responsible have not been identified. We studied a cohort of 16 RRMS patients experiencing URI and followed them for clinically identifiable attacks. The viral causes of 21 separate URIs were investigated using culture and polymerase chain reactio n (PCR) of nasal swab specimens, and by serology. Sibley’s ‘at-risk’ period for MS attacks, beginning two weeks before and continuing for five weeks after a URI, was used for the analysis. Seven of the nine (78%) URIs due to picornaviruses were associated with an MS attack during the at-risk period. By contrast, only two of 12 (17%) picornavirus-negative URIs were associated with an MS attack (P =0.01). The possible role of picornaviruses in the patho genesis of MS deserves further study.


2021 ◽  
Vol 17 (5) ◽  
pp. 31-35
Author(s):  
T.A. Odintsova ◽  
O.O. Kopchak

Multiple sclerosis is an insidious disabling, both physically and mentally, demyelinating disease of the central nervous system. People with multiple sclerosis, apart from the classic manifestations, can also experience depression and anxiety. The study was aimed to assess peculiarities of influence of socio-demographic, external factors, and characteristics of the disease on depression and anxiety among patients with relapsing-remitting multiple sclerosis. The following article highlights the main risk factors and their ways of influence on the aforementioned disorders, distinguished by the multifactorial analysis. Also, it estimates the frequency of different severity levels of either depression or anxiety depending on the pre-sence of each risk factor.


2017 ◽  
Vol 1 (3) ◽  
pp. 01-03
Author(s):  
Theodore Eric

Multiple sclerosis (MS) is a chronic inflammatory autoimmune demyelinating disease of the central nervous system. It affects approximately 400,000 people in the United States and onset is usually during young adulthood. There are four clinical forms of MS, of which relapsing remitting type is the most common. As the etiology of MS is unknown, finding a cure will remain challenging. The main mechanism of injury appears to be inflammation and 8 agents are now FDA approved to help control MS. These agents for relapsing forms of MS target different parts of the immune system, with the end goal of decreasing and avoiding further inflammation. No agents are FDA approved for the primary progressive version of MS. FDA approved agents include four preparations of interferon β (Avonex, Rebif, Betaseron and Extavia), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), natalizumab (Tysabri) and fingolimod (Gilenya). There are several drug undergoing phase II and III trials. The heterogeneity of the MS disease process, individual patient response, and medication toxicities continue to challenge the treating physician.


2017 ◽  
Vol 41 (S1) ◽  
pp. S632-S632
Author(s):  
A. Fornelos ◽  
V. Espírito Santo ◽  
M. Silva ◽  
M. Roque

IntroductionMultiple Sclerosis (MS) is considered an autoimmune inflammatory disease and it is the most common demyelinating disease of the central nervous system. Although its aetiology remains unknown, it has been considered to be multifactorial. MS tends to be more commonly diagnosed in young Caucasian women. It has been described four clinical courses: relapsing-remitting MS, primary progressive MS, secondary progressive MS and progressive remitting MS based on the temporal sequence in which the symptoms arise. Clinic is also very different because it depends on the sites where the lesions occur. The most frequent signs and symptoms are motor and visual deficits, paraesthesia, gait ataxia, diplopia, dizziness and bladder dysfunction. Depressive symptomatology is also among the most common symptoms of MS.ObjectivesShow the importance of depressive symptomatology in patients with MS.AimsEvaluation the connection between MS and depression.MethodsSearch for articles concerning MS and depression on Pubmed and Scielo databases from July 2014 through October 2016.ResultsPsychiatric manifestations, and especially depressive symptoms, affect almost 40% of MS patients in remission, and about 90% of those in a flare-up. This may be due to the diagnosis itself, with its large amount of symptoms and its variable progression, but also due to side effects of therapy. It gives a major contribute to suicidality (7.5%) when compared to the general population.ConclusionA combined approach and treatment is in order to diminish the incapacity caused by both these illnesses in every single patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Olfat Gamil Shaker ◽  
Amr Hassan ◽  
Asmaa Mohammed Mohammed ◽  
Shereen Rashad Mohammed

Abstract Background Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system (CNS). Long non-coding RNAs (lncRNAs) were believed to play a role in the pathogenesis of neurological disorders including MS. lincR-Ccr2-5′AS is expressed in the T helper2 (Th2) lineage. TNF-α heterogeneous nuclear ribonucleoprotein L (THRIL) causes the induction of TNF-α and regulates innate immune response and inflammation. We investigated the expression of lincR-Ccr2-5′AS and THRIL in MS to clarify their association with MS risk and the clinical features. Results LincR-Ccr2-5′AS was significantly downregulated in MS patients (fold change = 0.43±0.29, p = 0.03). The expression level was significantly low in patients with motor weakness and optic neuritis, patients with Expanded Disability Status Scale (EDSS) ≥5.5, and treatment-naïve patients. THRIL was significantly upregulated in MS patients (fold change = 6.18±2, p = 0.02). Its expression was significantly higher in patients with relapsing-remitting multiple sclerosis (RRMS), patients with motor weakness, patients with EDSS ≤5, and patients who received interferon. Conclusion Our results showed the downregulation of lincR-Ccr2-5′AS and the upregulation of lncRNA THRIL in MS patients. This differential expression of both lncRNAs may have an important role in MS pathogenesis.


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