11/47. Parkinsonism as a manifestation of multiple sclerosis.We describe a 48-year-old patient, with a diagnosis of relapsing-remitting multiple sclerosis, who presented to our service with a parkinsonian syndrome that markedly improved after corticosteroid treatment. To the best of our knowledge, only 12 cases of parkinsonism have been reported from 1970 to the present, of which only 8 seemed secondary to MS, i.e., those presenting conclusive imaging evidence or unequivocal response to corticosteroids.- - - - - - - - - - ranking = 1keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
12/47. multiple sclerosis, interferon beta and clinical thyroid dysfunction.The objective of this study was to investigate frequency and presentation of clinical thyroid dysfunction in patients treated with interferon beta (IFN-beta). We have collected the cases of clinical thyroid dysfunction in 700 consecutive patients receiving IFN-beta for multiple sclerosis (MS). Five patients (four women, one man) treated with IFN-beta1b developed hyperthyroidism. Three of them have secondary progressive MS, and two have relapsing-remitting MS. It was necessary to stop IFN-beta in three cases; these patients still require carbimazole after several months. In the two other cases, hyperthyroidism disappeared spontaneously. Two patients (one man and one woman) treated with IFN-beta1a developed hypothyroidism. One of them required l-thyroxine. Lastly, an increased thyroid volume without modification of thyroid hormones plasma levels was discovered in a patient receiving IFN-beta1a. Among patients treated with IFN-beta, clinical thyroid dysfunction is much rarer than laboratory thyroid dysfunction. However, this side-effect is sometimes severe.- - - - - - - - - - ranking = 0.24815229901244keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
13/47. Longitudinal study of chemokine receptor expression on peripheral lymphocytes in multiple sclerosis: CXCR3 upregulation is associated with relapse.The interaction between chemokines and their receptors leads to selective recruitment of cells to foci of inflammation. cross-sectional studies have reported significantly different expression of chemokine receptors CXCR3, CCR5 and CCR2 on peripheral blood lymphocytes in multiple sclerosis (MS) compared with controls. cells expressing these receptors are likely to play a pathogenic role as suggested by studies of experimental autoimmune encephalomyelitis. Also, immunogenetic studies of nonfunctional CCR5 receptors in MS patients, due to 32delta deletion, demonstrated a delay in time to next relapse. The aims of this study were to detect any changes in the serial expression of chemokine receptors CCR2, CCR3, CCR5 and CXCR3 on peripheral blood CD4 lymphocytes from patients with MS and to correlate the changes with relapses. Upregulation of CXCR3 expression on peripheral blood CD4 lymphocytes was associated with all relapses and CCR5 expression was significantly affected with all relapses. Clinical recovery, with or without intravenous methylprednisolone treatment, coincided with the return of CXCR3 towards baseline in all but one case. Fluctuation in the expression of CXCR3 and CCR5 was also significantly greater in clinically stable patients with MS compared with controls, which may be due to subclinical disease activity. These findings provide further support for the view that CXCR3 and CCR5 antagonists could have a therapeutic value in MS.- - - - - - - - - - ranking = 1.0000649993658keywords = multiple sclerosis, sclerosis, ms (Clic here for more details about this article) |
14/47. Glatiramer acetate treatment in patients with childhood and juvenile onset multiple sclerosis.BACKGROUND: Recent data indicate that in multiple sclerosis disease onset before the age of 16 is more common than previously assumed. However, current therapeutic options are limited to the treatment of acute attacks in these patients. Glatiramer acetate has been successfully applied in adults with relapsing-remitting multiple sclerosis, but there are no data available about the use of glatiramer acetate in childhood and juvenile onset multiple sclerosis. methods: Seven patients with relapsing-remitting multiple sclerosis and disease onset between 9 and 16 years of age were treated with daily subcutaneous injection of 20 mg glatiramer acetate (Copaxone). patients were followed for 24 months. Treatment was initiated in all patients before the age of 18. RESULTS: The use of glatiramer acetate in our cohort of early onset multiple sclerosis patients was safe and well tolerated. Two out of seven patients remained relapse-free during the two year period. Clinical disability as measured by the EDSS remained stable in three out of seven patients. CONCLUSION: Due to the small number of patients the efficacy of the treatment has to be interpreted with caution. However, there might be a more pronounced treatment benefit in patients with low disability at treatment initiation and early treatment onset.- - - - - - - - - - ranking = 1.8keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
15/47. Problems in diagnosing cranial base meningioma in patients with multiple sclerosis.A 49-year-old patient had been suffering from the relapsing-remitting form of multiple sclerosis since the age of 23. Attacks of the disease appeared every 2 years in the form of right-sided hemiparesis, vertigo, and problems in maintaining balance. The symptoms disappeared after treatment. At the age 32 retrobulbar inflammation of the second cranial nerve appeared with visual acuity weakness. The symptoms disappeared after treatment. At the age of 42, bilateral weakness of visual acuity appeared and then epileptic attacks occurred. After surgical treatment of meningioma the symptoms disappeared. Only the features of a psycho-organic syndrome remained. The following attack of MS appeared 2 years after surgical intervention. MRI of the head disclosed numerous demyelinating foci.- - - - - - - - - - ranking = 1.0005199949261keywords = multiple sclerosis, sclerosis, ms (Clic here for more details about this article) |
16/47. Acute verbal dyspraxia, a rare presentation in multiple sclerosis: a case report with MRI localization.Cortical speech disorders rarely occur in multiple sclerosis (MS). We report a patient with relapsing-remitting MS, who presented with acute verbal dyspraxia. magnetic resonance imaging (MRI) demonstrated an acute T2/Flair hyperintense, primarily white matter lesion underlying the middle third of the inferior frontal gyrus. The verbal dyspraxia cleared beginning 48 hours after the initiation of iv dexamethasone. Follow-up MRI demonstrated qualitative and quantitative diminution of the hyperintensity. This is the first report of a clinically definite MS patient with acute verbal dyspraxia. Moreover, there was a suggestive localization of verbal praxis to Brodmann areas 44/45.- - - - - - - - - - ranking = 1keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
17/47. Prinzmetal variant angina associated with multiple sclerosis.We report the case of a young woman with an acute coronary syndrome in the setting of a multiple sclerosis exacerbation. A connection between the 2, possibly caused by spinal cord pathology, is suggested.- - - - - - - - - - ranking = 1keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
18/47. Relapsing and remitting multiple sclerosis: pathology of the newly forming lesion.The study describes the clinical and pathological findings in 12 patients with relapsing and remitting multiple sclerosis, who died during or shortly after the onset of a relapse. Pathological changes not previously associated with the formation of new symptomatic lesions were observed in seven cases, namely, extensive oligodendrocyte apoptosis and microglial activation in myelinated tissue containing few or no lymphocytes or myelin phagocytes. No current laboratory model of multiple sclerosis, in particular, experimental allergic encephalomyelitis, is known with these features, which raises the possibility of some novel process underlying new lesion formation in multiple sclerosis.- - - - - - - - - - ranking = 1.4keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
19/47. Normal brain activation in hemiatrophy due to multiple sclerosis: a functional MRI case study.Evidence from recent functional magnetic resonance imaging studies suggests that adaptive cortical changes ('plasticity') could participate in the maintenance of function in multiple sclerosis (MS). Here, we addressed the impact of brain atrophy on the pattern of cerebral activation in an MS patient with a relapsing-remitting course. This patient showed mildly disabling hemiparesis of the left side (EDSS 2.0), and corresponding brain hemiatrophy (15% volume reduction) of the right hemisphere. The clinical syndrome was considered to result from a lesion in the corona radiata involving corticospinal fibers. Motor-evoked potential recordings confirmed substantial axonal damage to the pyramidal tract arising from that hemisphere. Irrespective of these asymmetries, normal brain activation was found for hand and foot movements for both brain sides. This demonstrates that brain atrophy itself does not necessarily induce cortical adaptive changes, even if mild disability is present. On the other hand, significantly disabling distinct clinical syndromes e.g. arising from spinal cord lesions may evoke cortical changes irrespective of brain atrophy. This issue has to be studied in longitudinal investigations.- - - - - - - - - - ranking = 1keywords = multiple sclerosis, sclerosis (Clic here for more details about this article) |
20/47. Foreign accent syndrome in a patient with multiple sclerosis.BACKGROUND: Foreign accent syndrome is a speech disorder which leads listeners to perceive the patient as having a foreign accent. It has been recognized previously after stroke, brain injury or unknown causes. CASE REPORT: A 52-year-old woman with clinically definite relapsing remitting multiple sclerosis (MS) presented with episodes of what was perceived as a Dutch accent along with other neurologic symptoms that would resolve simultaneously. She was assessed by a speech therapist both during an episode and after complete recovery. Speech and MRI changes (showing deep white matter lesions in the corpus callosum, left pariental lobe and left frontal lobe) were consistent with previous reports of foreign accent syndrome. CONCLUSIONS: This patient's episodes of foreign accent are thought to be due to her MS.- - - - - - - - - - ranking = 1.0000649993658keywords = multiple sclerosis, sclerosis, ms (Clic here for more details about this article) |
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