Pub Date : 2017-08-23DOI: 10.4172/2376-0389.1000208
S. Feketova, I. Waczulíková, P. Valkovič, J. Mareš
Central pain (CP) is little recognized and diagnosed type of pain in multiple sclerosis. Objective: This second part of our work related to pain in multiple sclerosis is concentrated on occurrence of CP and defined its characteristics. Methods: Questionnaires on pain were sent to 307 patients with definitive multiple sclerosis diagnose. Patients admitting to CP were examined with aim to diagnose CP. The dates were statistically processed. Results: Out of 220 responders 92% reported pain during the course of their multiple sclerosis. CP was found in 57.72%, including 40.91% with central neuropathic extremity and trunk pain (CNEP), 5.91% with trigeminal neuralgia (TN), and 33.18% with Lhermitte‘s sign (LS). In 28.8% of all patients, CP was an initial multiple sclerosis symptom. The prevalence of CP does not increase with age, disease duration, or the Expanded Disability Status Scale (EDSS). Lower extremities were the commonest location of CNEP (74.5%) and burning was the commonest painful sensation. Three and more concurrent unpleasant painful sensations experienced 68.9% of patients, which were in 46.7% located in the lower extremities. Three and more concurrent CP locations (including TN and LS) were reported by 89% of patients. Number of locations in CP increases significantly with age and EDSS, in contrast to group with nociceptive and peripheral neuropathic pain (n=113), where does not increase with age, EDSS and multiple sclerosis duration. The group with nociceptive and peripheral neuropathic pain featured significantly less patients with only one pain location (p=0.0269) and only one pain quality. In contrast to the other group, In CP increases significantly the number of patients with increase the number of concurrent pain qualities (p<0.0001). Conclusion: CP is not only a frequent complaint among persons with multiple sclerosis, but is a distinctive type of pain requiring special attention and their identification remains still the major challenge.
{"title":"Central Pain in Patients with Multiple sclerosis","authors":"S. Feketova, I. Waczulíková, P. Valkovič, J. Mareš","doi":"10.4172/2376-0389.1000208","DOIUrl":"https://doi.org/10.4172/2376-0389.1000208","url":null,"abstract":"Central pain (CP) is little recognized and diagnosed type of pain in multiple sclerosis. \u0000Objective: This second part of our work related to pain in multiple sclerosis is concentrated on occurrence of CP and defined its characteristics. \u0000Methods: Questionnaires on pain were sent to 307 patients with definitive multiple sclerosis diagnose. Patients admitting to CP were examined with aim to diagnose CP. The dates were statistically processed. \u0000Results: Out of 220 responders 92% reported pain during the course of their multiple sclerosis. CP was found in 57.72%, including 40.91% with central neuropathic extremity and trunk pain (CNEP), 5.91% with trigeminal neuralgia (TN), and 33.18% with Lhermitte‘s sign (LS). In 28.8% of all patients, CP was an initial multiple sclerosis symptom. The prevalence of CP does not increase with age, disease duration, or the Expanded Disability Status Scale (EDSS). Lower extremities were the commonest location of CNEP (74.5%) and burning was the commonest painful sensation. Three and more concurrent unpleasant painful sensations experienced 68.9% of patients, which were in 46.7% located in the lower extremities. Three and more concurrent CP locations (including TN and LS) were reported by 89% of patients. Number of locations in CP increases significantly with age and EDSS, in contrast to group with nociceptive and peripheral neuropathic pain (n=113), where does not increase with age, EDSS and multiple sclerosis duration. The group with nociceptive and peripheral neuropathic pain featured significantly less patients with only one pain location (p=0.0269) and only one pain quality. In contrast to the other group, In CP increases significantly the number of patients with increase the number of concurrent pain qualities (p<0.0001). \u0000Conclusion: CP is not only a frequent complaint among persons with multiple sclerosis, but is a distinctive type of pain requiring special attention and their identification remains still the major challenge.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"13 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75132986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-11DOI: 10.4172/2376-0389.1000207
Kathrin S Muller-Wielsch, B. Cannella, C. Raine
Objective: While traditionally a disorder of myelin, in multiple sclerosis (MS) neuronal and axonal damage has in recent years become an important topic of clinical relevance. To address this, alterations in neurofilament phosphorylation, known markers of neuronal health, were investigated in anterior horn cells in MS spinal cord tissue for signs of motor neuron damage. Methods: Spinal cord tissue was examined from 13 MS and 6 control patients. Fresh frozen sections were labelled with antibodies against phosphorylated and non-phosphorylated epitopes of neurofilament H (NF-H) and analyzed by light microscopy. Results: In MS, increased expression of phosphorylated NF-H in spinal motor neuron perikarya (abnormal for neurons) occurred in 61.5% of cases, mostly in chronic active lesions, with the strongest immunoreactivity at the lumbar level. Inflammatory activity was common in chronic active but rare in chronic silent lesions. In one case with an acute lesion, we saw swollen axons positive for non-phosphorylated NF-H, a pathologic marker in axons, but no signs of perikaryal damage. Expression of non-phosphorylated NF-H in spinal motor neuron perikarya was similar in both MS and controls. Conclusion: In line with previous studies, our findings implicate anterior horn cell damage as a common feature in MS. We propose that underlying mechanisms may involve reduced synaptic input and/or retrograde degeneration, subjects which remain to be investigated.
{"title":"Multiple Sclerosis: Neurofilament Pathology in Spinal Motor Neurons","authors":"Kathrin S Muller-Wielsch, B. Cannella, C. Raine","doi":"10.4172/2376-0389.1000207","DOIUrl":"https://doi.org/10.4172/2376-0389.1000207","url":null,"abstract":"Objective: While traditionally a disorder of myelin, in multiple sclerosis (MS) neuronal and axonal damage has in recent years become an important topic of clinical relevance. To address this, alterations in neurofilament phosphorylation, known markers of neuronal health, were investigated in anterior horn cells in MS spinal cord tissue for signs of motor neuron damage. \u0000Methods: Spinal cord tissue was examined from 13 MS and 6 control patients. Fresh frozen sections were labelled with antibodies against phosphorylated and non-phosphorylated epitopes of neurofilament H (NF-H) and analyzed by light microscopy. \u0000Results: In MS, increased expression of phosphorylated NF-H in spinal motor neuron perikarya (abnormal for neurons) occurred in 61.5% of cases, mostly in chronic active lesions, with the strongest immunoreactivity at the lumbar level. Inflammatory activity was common in chronic active but rare in chronic silent lesions. In one case with an acute lesion, we saw swollen axons positive for non-phosphorylated NF-H, a pathologic marker in axons, but no signs of perikaryal damage. Expression of non-phosphorylated NF-H in spinal motor neuron perikarya was similar in both MS and controls. \u0000Conclusion: In line with previous studies, our findings implicate anterior horn cell damage as a common feature in MS. We propose that underlying mechanisms may involve reduced synaptic input and/or retrograde degeneration, subjects which remain to be investigated.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"29 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85220751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-04DOI: 10.4172/2376-0389.1000206
Klára Novotná, J. Preiningerova, L. Sobíšek, E. Havrdová
Background: Gait impairment represents one of the most common symptoms of multiple sclerosis (MS). Fampridine is the first symptomatic treatment aimed at improving gait. An objective measurement of the mobility improvement from treatment initiation has been recommended to evaluate treatment response. Objective: In this retrospective observational study, we evaluated what improvement in walking speed can be expected in people with multiple sclerosis (MS) treated with Fampridine in clinical practice, with respect to specific disability levels (EDSS 4.0-7.0). Methods: The mobility tests including the Timed 25 foot walk test (T25FW), Timed Up and Go test (TUG) and Step test (ST) were performed just before and 3 h after administration of Fampridine 10 mg tablet. Results: One hundred and thirty one (131) people with MS (15 with primary progressive, 40 with secondary progressive and 76 people with relapsing-remitting MS). The mean age was 48 years (SD 9.8), mean MS duration was 19, 8 years, 58% were women. The range of treatment response of Fampridine, measured with the T25FW test, varied from 11-41%. Contrary to prior reports, the baseline T25FW and the percentage of improvement in T25FW was significantly correlated. Conclusion: Assessment of treatment response outside of a clinical trial is challenging and may require different outcome measures compared to RCT. For MS patients with moderate disability seems TUG test or Step test more appropriate for quantifying treatment response.
{"title":"What Variability of Treatment Effect of Fampridine Can We Expect in People with Multiple Sclerosis","authors":"Klára Novotná, J. Preiningerova, L. Sobíšek, E. Havrdová","doi":"10.4172/2376-0389.1000206","DOIUrl":"https://doi.org/10.4172/2376-0389.1000206","url":null,"abstract":"Background: Gait impairment represents one of the most common symptoms of multiple sclerosis (MS). Fampridine is the first symptomatic treatment aimed at improving gait. \u0000An objective measurement of the mobility improvement from treatment initiation has been recommended to evaluate treatment response. \u0000Objective: In this retrospective observational study, we evaluated what improvement in walking speed can be expected in people with multiple sclerosis (MS) treated with Fampridine in clinical practice, with respect to specific disability levels (EDSS 4.0-7.0). \u0000Methods: The mobility tests including the Timed 25 foot walk test (T25FW), Timed Up and Go test (TUG) and Step test (ST) were performed just before and 3 h after administration of Fampridine 10 mg tablet. \u0000Results: One hundred and thirty one (131) people with MS (15 with primary progressive, 40 with secondary progressive and 76 people with relapsing-remitting MS). The mean age was 48 years (SD 9.8), mean MS duration was 19, 8 years, 58% were women. The range of treatment response of Fampridine, measured with the T25FW test, varied from 11-41%. \u0000Contrary to prior reports, the baseline T25FW and the percentage of improvement in T25FW was significantly correlated. \u0000Conclusion: Assessment of treatment response outside of a clinical trial is challenging and may require different outcome measures compared to RCT. For MS patients with moderate disability seems TUG test or Step test more appropriate for quantifying treatment response.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"45 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76587018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-18DOI: 10.4172/2376-0389.1000205
L. Strober
Objectives: Personality is known to have a substantial impact on health and overall well-being. Neuroticism, extraversion, and conscientiousness in particular have been shown to be strongly correlated with subjective well-being (SWB), psychological well-being (PWB), and overall health. The present study aimed to examine the role of personality and its relationship to SWB, PWB, and health in a multiple sclerosis (MS) sample. Methods: One hundred and seventy-two individuals with MS completed measures of personality, SWB, PWB, and health. Pearson correlations were conducted to examine the relationship among these factors. Results: Consistent with what has been shown in the general, healthy population personality has a strong correlation with many aspects of well-being and health. This was particularly true for neuroticism and extraversion, and to a lesser extent, conscientiousness. Openness and agreeableness demonstrated the weakest associations. Conclusion: The role of personality on well-being and health has long been established. The present study is one of the first to examine these associations in a MS sample. Findings suggest that assessment of personality should be considered part of routine care for individuals with MS in hopes of tailoring interventions to assure maintenance and/ or improvement in well-being and health.
{"title":"Well-Being and Perceived Health in Multiple Sclerosis (MS): The Role of Personality","authors":"L. Strober","doi":"10.4172/2376-0389.1000205","DOIUrl":"https://doi.org/10.4172/2376-0389.1000205","url":null,"abstract":"Objectives: Personality is known to have a substantial impact on health and overall well-being. Neuroticism, extraversion, and conscientiousness in particular have been shown to be strongly correlated with subjective well-being (SWB), psychological well-being (PWB), and overall health. The present study aimed to examine the role of personality and its relationship to SWB, PWB, and health in a multiple sclerosis (MS) sample. \u0000Methods: One hundred and seventy-two individuals with MS completed measures of personality, SWB, PWB, and health. Pearson correlations were conducted to examine the relationship among these factors. \u0000Results: Consistent with what has been shown in the general, healthy population personality has a strong correlation with many aspects of well-being and health. This was particularly true for neuroticism and extraversion, and to a lesser extent, conscientiousness. Openness and agreeableness demonstrated the weakest associations. \u0000Conclusion: The role of personality on well-being and health has long been established. The present study is one of the first to examine these associations in a MS sample. Findings suggest that assessment of personality should be considered part of routine care for individuals with MS in hopes of tailoring interventions to assure maintenance and/ or improvement in well-being and health.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"8 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87224091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-22DOI: 10.4172/2376-0389.1000204
Walter Fierz
Multiple Sclerosis (MS) is generally considered an autoimmune disease, mainly because the preferred and wellstudied animal models for the disease are autoimmune models. In human disease, however, evidence for autoimmunity in MS has been sought for a long time with marginal results. On the other hand, two viruses, EBV and HHV-6A, play an etio-pathogenic role and, as recently discussed, their mutual interaction might be a key element in the pathogenesis of MS. This short review summarizes evidence that supports this view of changing the paradigm about the etio-pathogenesis of MS from autoimmunity to viral.
{"title":"Pathogenesis of Multiple Sclerosis: How Much Space is Left for Autoimmunity?","authors":"Walter Fierz","doi":"10.4172/2376-0389.1000204","DOIUrl":"https://doi.org/10.4172/2376-0389.1000204","url":null,"abstract":"Multiple Sclerosis (MS) is generally considered an autoimmune disease, mainly because the preferred and wellstudied animal models for the disease are autoimmune models. In human disease, however, evidence for autoimmunity in MS has been sought for a long time with marginal results. On the other hand, two viruses, EBV and HHV-6A, play an etio-pathogenic role and, as recently discussed, their mutual interaction might be a key element in the pathogenesis of MS. This short review summarizes evidence that supports this view of changing the paradigm about the etio-pathogenesis of MS from autoimmunity to viral.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73845521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-17DOI: 10.4172/2376-0389.1000202
G. Nicoletti, P. Valentino, C. Chiriaco, A. Granata, S. Barone, E. Filippelli, M. Caligiuri, B. Vescio, A. Sarica, A. Quattrone
Background: Using Diffusion Tensor Imaging (DTI), we tested the hypothesis that cerebellar abnormalities in fractional anisotropy (FA) may be involved in cognitive dysfunctions in Relapsing-Remitting (RR)-Multiple Sclerosis (MS). Objective: The aim of our study was to investigate the microstructural integrity in MS of regions that connect in both feedforward and feedback pathways to cortical areas, i.e., Superior Cerebellar Peduncles (SCP), Middle Cerebellar Peduncles (MCP), Dentate nuclei (DN) and Thalamus (Th). Patients and methods: We studied 46 patients with RR-MS (21 with cerebellar signs and 25 without) and 23 normal subjects. All subjects underwent cognitive testing. Results: In patients with a cerebellar phenotype, cognitive performance in all considered domains was from moderately to strongly related (p<0.05) to abnormalities of SCP (r=0.119 to 0.735) and Thalamus (r=0.477 to 0.602). Discussion: Our study showed an important correlation between cognitive testing and FA values of SCP and thalamus in cerebellar MS patients. We found not only the involvement of thalamus but also of SCP that is an important link between cerebellar nuclei and thalamus, suggesting that a disconnection is present also out of the thalamus. These results suggest that SCP and thalamic damage is a clinically relevant biomarker of the neurodegenerative cerebellar process in MS.
{"title":"Superior Cerebellar Peduncle Atrophy Predicts Cognitive Impairment in Relapsing Remitting Multiple Sclerosis Patients with Cerebellar Symptoms: A DTI Study","authors":"G. Nicoletti, P. Valentino, C. Chiriaco, A. Granata, S. Barone, E. Filippelli, M. Caligiuri, B. Vescio, A. Sarica, A. Quattrone","doi":"10.4172/2376-0389.1000202","DOIUrl":"https://doi.org/10.4172/2376-0389.1000202","url":null,"abstract":"Background: Using Diffusion Tensor Imaging (DTI), we tested the hypothesis that cerebellar abnormalities in fractional anisotropy (FA) may be involved in cognitive dysfunctions in Relapsing-Remitting (RR)-Multiple Sclerosis (MS). \u0000Objective: The aim of our study was to investigate the microstructural integrity in MS of regions that connect in both feedforward and feedback pathways to cortical areas, i.e., Superior Cerebellar Peduncles (SCP), Middle Cerebellar Peduncles (MCP), Dentate nuclei (DN) and Thalamus (Th). \u0000Patients and methods: We studied 46 patients with RR-MS (21 with cerebellar signs and 25 without) and 23 normal subjects. All subjects underwent cognitive testing. \u0000Results: In patients with a cerebellar phenotype, cognitive performance in all considered domains was from moderately to strongly related (p<0.05) to abnormalities of SCP (r=0.119 to 0.735) and Thalamus (r=0.477 to 0.602). \u0000Discussion: Our study showed an important correlation between cognitive testing and FA values of SCP and thalamus in cerebellar MS patients. We found not only the involvement of thalamus but also of SCP that is an important link between cerebellar nuclei and thalamus, suggesting that a disconnection is present also out of the thalamus. These results suggest that SCP and thalamic damage is a clinically relevant biomarker of the neurodegenerative cerebellar process in MS.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"70 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76228137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-05DOI: 10.4172/2376-0389.1000199
Mehdi Saeedan, Y. G. Ko, Sudhir Kumar Palat Chirakkara, S. Sinha, A. Shatila
Background: Hypovitaminosis D is amongst those strongly suggested risk factors for multiple sclerosis (MS). Although the association of vitamin D deficiency with MS has been established in several studies in recent years, there are not many studies to assess and compare the degree of Hypovitaminosis D status of newly diagnosed patients with multiple sclerosis versus control group worldwide, especially in UAE. Objective: To compare and observe the state of Hypovitaminosis D in newly diagnosed cases of multiple sclerosis versus control group and to determine presence of any significant association. Methods: In this retrospective study, 30 cases of newly diagnosed multiple sclerosis were randomly selected and matched for age and sex with 30 controls. Demographics and serum vitamin D level for both groups were evaluated. Appropriate statistical analysis was performed to show any significant association. Results: An independent-samples t-test was conducted. There was a significant difference in Vitamin D level for MS (Mean=37.08, SD=17.63) and control group (Mean=58.103, SD=21.5323); p<0.05. Conclusion: Findings of this study suggest: 1. There is significant association between vitamin D deficiency and Multiple Sclerosis 2. Hypovitaminosis D may be a contributing factor in lowering the mean age of MS diagnosis. We propose early evaluation for vitamin D insufficiency in cases of MS and emphasis on restoring serum vitamin D to satisfactory levels as part of clinical management of MS. It would be worthwhile doing a large randomized trial to establish the safety and efficacy needed to promote large-scale vitamin D supplementation.
{"title":"Hypovitaminosis D Status in Newly Diagnosed Cases of MS versus Control Group","authors":"Mehdi Saeedan, Y. G. Ko, Sudhir Kumar Palat Chirakkara, S. Sinha, A. Shatila","doi":"10.4172/2376-0389.1000199","DOIUrl":"https://doi.org/10.4172/2376-0389.1000199","url":null,"abstract":"Background: Hypovitaminosis D is amongst those strongly suggested risk factors for multiple sclerosis (MS). Although the association of vitamin D deficiency with MS has been established in several studies in recent years, there are not many studies to assess and compare the degree of Hypovitaminosis D status of newly diagnosed patients with multiple sclerosis versus control group worldwide, especially in UAE. \u0000Objective: To compare and observe the state of Hypovitaminosis D in newly diagnosed cases of multiple sclerosis versus control group and to determine presence of any significant association. \u0000Methods: In this retrospective study, 30 cases of newly diagnosed multiple sclerosis were randomly selected and matched for age and sex with 30 controls. Demographics and serum vitamin D level for both groups were evaluated. Appropriate statistical analysis was performed to show any significant association. \u0000Results: An independent-samples t-test was conducted. There was a significant difference in Vitamin D level for MS (Mean=37.08, SD=17.63) and control group (Mean=58.103, SD=21.5323); p<0.05. \u0000Conclusion: Findings of this study suggest: \u00001. There is significant association between vitamin D deficiency and Multiple Sclerosis 2. Hypovitaminosis D may be a contributing factor in lowering the mean age of MS diagnosis. We propose early evaluation for vitamin D insufficiency in cases of MS and emphasis on restoring serum vitamin D to satisfactory levels as part of clinical management of MS. It would be worthwhile doing a large randomized trial to establish the safety and efficacy needed to promote large-scale vitamin D supplementation.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"49 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75329695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-29DOI: 10.4172/2376-0389.1000200
S. Bouomrani, N. Belgacem, F. Rekik, N. Lassoued, S. Trabelsi, Hassen Baïli, M. Béji
Optic neuritis is a common manifestation of multiple sclerosis. It occurs in two thirds of patients at some point in the course of this disease and is usually unilateral, acute and often recurrent. However, optic neuritis can be the first manifestation of this demyelinating disease in 15 to 20% of cases. Bilateral, simultaneous and retrobulbar forms of optic neuritis inaugurating multiple sclerosis remain exceptional and unusual. They represent a real diagnostic challenge and require special attention from the clinician Herein we report the case of bilateral simultaneous and isolated retrobulbar optic neuritis inaugurating multiple sclerosis in a 24 year old woman.
{"title":"Bilateral and Simultaneous Retrobulbar Optic Neuritis Revealing Multiple Sclerosis","authors":"S. Bouomrani, N. Belgacem, F. Rekik, N. Lassoued, S. Trabelsi, Hassen Baïli, M. Béji","doi":"10.4172/2376-0389.1000200","DOIUrl":"https://doi.org/10.4172/2376-0389.1000200","url":null,"abstract":"Optic neuritis is a common manifestation of multiple sclerosis. It occurs in two thirds of patients at some point in the course of this disease and is usually unilateral, acute and often recurrent. However, optic neuritis can be the first manifestation of this demyelinating disease in 15 to 20% of cases. \u0000Bilateral, simultaneous and retrobulbar forms of optic neuritis inaugurating multiple sclerosis remain exceptional and unusual. They represent a real diagnostic challenge and require special attention from the clinician \u0000Herein we report the case of bilateral simultaneous and isolated retrobulbar optic neuritis inaugurating multiple sclerosis in a 24 year old woman.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"27 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83619751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-26DOI: 10.4172/2376-0389.1000201
Y. Fragoso, M. Cardoso
Objective: Alcohol consumption has been linked with increased risk and worse outcomes in multiple sclerosis (MS). However, the results are not uniform and conflicting data on the matter have been published. This systematic review addresses the association of alcohol with increased risk and worse outcomes in MS. Method: Systematic review of the literature, searching for the terms "Alcohol" AND "Multiple Sclerosis" OR "MS" in the Medline, PubMed, Lilacs, SciELO and Google Scholar databases. References from selected articles were used to identify studies that might not previously have been recognized as pertinent to this review. The period established for searching for articles started in 1983, after publication of Poser’s criteria for diagnosing MS and finished on July 31, 2016. Results: The initial search identified 1399 potential papers from the search terms selected. After exclusion of duplications and articles that did not fulfil the criteria of the review, 30 papers were selected for full-text discussion. Eleven research articles published between 2004 and 2016 were included in this review. Alcohol consumption was considered to be a risk factor for development of MS by some authors but not by others. Some studies even reported that drinking small amounts of alcohol had a protective effect against developing MS. Alcohol seemed to have a negative effect on disability progression in MS. Data from different countries and cultures may have played a role in the results from the studies. Conclusion: It has been suggested that alcohol use might be related both to bad and to good outcomes in MS. There are no recommendations on doses that might be acceptable.
{"title":"Is Alcohol Harmful for Patients with Multiple Sclerosis","authors":"Y. Fragoso, M. Cardoso","doi":"10.4172/2376-0389.1000201","DOIUrl":"https://doi.org/10.4172/2376-0389.1000201","url":null,"abstract":"Objective: Alcohol consumption has been linked with increased risk and worse outcomes in multiple sclerosis (MS). However, the results are not uniform and conflicting data on the matter have been published. This systematic review addresses the association of alcohol with increased risk and worse outcomes in MS. Method: Systematic review of the literature, searching for the terms \"Alcohol\" AND \"Multiple Sclerosis\" OR \"MS\" in the Medline, PubMed, Lilacs, SciELO and Google Scholar databases. References from selected articles were used to identify studies that might not previously have been recognized as pertinent to this review. The period established for searching for articles started in 1983, after publication of Poser’s criteria for diagnosing MS and finished on July 31, 2016. Results: The initial search identified 1399 potential papers from the search terms selected. After exclusion of duplications and articles that did not fulfil the criteria of the review, 30 papers were selected for full-text discussion. Eleven research articles published between 2004 and 2016 were included in this review. Alcohol consumption was considered to be a risk factor for development of MS by some authors but not by others. Some studies even reported that drinking small amounts of alcohol had a protective effect against developing MS. Alcohol seemed to have a negative effect on disability progression in MS. Data from different countries and cultures may have played a role in the results from the studies. Conclusion: It has been suggested that alcohol use might be related both to bad and to good outcomes in MS. There are no recommendations on doses that might be acceptable.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"4 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81563037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-30DOI: 10.4172/2376-0389.1000198
S. Viswanathan, Kamil Mkm
Ankylosing spondylitis (AS) and multiple sclerosis (MS) are two different chronic inflammatory autoimmune conditions with unclear etiopathogenesis. One is a rheumatological disorder while the other is a neurological one. Current literature on an association between these two conditions is limited. Furthermore, early recognition of potential cases with both conditions co-existing is important as there have been very rare reports on the occurrence of demyelinating diseases or unmasking of latent MS in patients with ankylosing spondylitis treated with anti-TNFα. This has important therapeutic implications for patients at such risk.
{"title":"Co-Existence of Relapsing Remitting Multiple Sclerosis and HLA B27 PositiveAnkylosing Spondylitis in a Malay Male: A Rare Occurrence","authors":"S. Viswanathan, Kamil Mkm","doi":"10.4172/2376-0389.1000198","DOIUrl":"https://doi.org/10.4172/2376-0389.1000198","url":null,"abstract":"Ankylosing spondylitis (AS) and multiple sclerosis (MS) are two different chronic inflammatory autoimmune conditions with unclear etiopathogenesis. One is a rheumatological disorder while the other is a neurological one. Current literature on an association between these two conditions is limited. Furthermore, early recognition of potential cases with both conditions co-existing is important as there have been very rare reports on the occurrence of demyelinating diseases or unmasking of latent MS in patients with ankylosing spondylitis treated with anti-TNFα. This has important therapeutic implications for patients at such risk.","PeriodicalId":16369,"journal":{"name":"Journal of multiple sclerosis","volume":"33 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85027294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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