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Impairment of vertical saccades from an acute pontine lesion in multiple sclerosis.

A 62-year-old woman with relapsing-remitting multiple sclerosis suddenly complained of diplopia associated with bilateral adduction impairment, nystagmus of the abducting eye bilaterally, and sparing of abduction, convergence, and vertical eye movements, consistent with bilateral internuclear ophthalmoplegia. Within 1 week, she had developed a complete horizontal gaze paralysis even with the oculocephalic maneuver. Vertical saccades were slow and convergence was preserved. There was a right lower motor neuron seventh cranial nerve palsy. Brain MRI showed a new enhancing lesion involving the po…

Vestibular findings in relapsing, remitting multiple sclerosis: a study of thirty patients.

Our objective was to describe vestibular abnormalities in patients with relapsing and remitting multiple sclerosis. Thirty patients (6 men and 24 women) between 27 and 64 years of age underwent neurological and otolaryngological examinations, complete anamnesis, and electronystagmography. Patients with psychological or oculomotor paresis (or both), internuclear ophthalmoparesis, severe visual disturbances, or locomotion restrictions were excluded. The difference-of-proportion test was used to compare affected patients with controls, with a significance level of 5%. Vestibular alterations were …

Clinical characteristics of multiple sclerosis and associated optic neuritis in Korean children.

PURPOSE: To study the clinical characteristics of multiple sclerosis and associated optic neuritis in Korean children. METHOD: A retrospective analysis was performed on 10 patients with an onset of multiple sclerosis before age 16. Information on sex, age of onset, clinical course, laboratory findings, and clinical characteristics of optic neuritis was obtained. RESULT: The mean age at presentation was 7.31 +/- 2.99 years, and the mean duration of observation was 36.2 +/- 26.1 months. No female predilection (50%) was observed. The disease presented as relapsing-remitting type multiple sclero…

Bullous pemphigoid and multiple sclerosis: a report of two cases with ELISA test.

We report two patients with longstanding multiple sclerosis (MS) who developed vesicles and bullae consistent with the diagnosis of bullous pemphigoid (BP). Both patients showed linear IgG at the dermal-epidermal junction, located on the epidermal side of patients' skin previously treated with 1M NaCl. In the two cases, the ELISA test was positive for the extracellular fragment of BP 180. However, the indirect immunofluorescence test (IIF) was repeatedly negative. Therapy either with prednisone plus dapsone or prednisone alone was initiated and the disease was controlled after 23 and 15 months…

[Subarachnoid anesthesia for cesarean section in a patient with multiple sclerosis: case report.].

BACKGROUND AND OBJECTIVES: Multiple sclerosis is an acquired disease characterized by demyelinated areas in the brain and spinal cord. The clinical presentation depends on the anatomical areas involved. The main causes of death are infection, respiratory failure, and status epilepticus. It affects genetically predisposed patients after contact with environmental factors, especially viruses. The objective of this report was to present the anesthetic technique used in a patient with multiple sclerosis undergoing cesarean section. CASE REPORT: A 32-year old patient, 60 kg, with multiple sclerosi…

A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis.

Untreated patients with relapsing-remitting multiple sclerosis (RRMS) have an elevated risk of exacerbation in the first 3 months postpartum. Pregnant patients (n =173) with RRMS and with at least one relapse in the two years before pregnancy were enrolled in this multinational, multicentre, randomized double-blind clinical trial investigating different doses of intravenous immunoglobulin (IVIG) treatment in the 6 months postpartum. Group I (unloaded) received 150 mg/kg body weight (BW) IVIG on Day 1, then placebo infusions on Day 2 and Day 3. Group II (loaded) received 450, 300 and 150 mg/kg …

Clinical and demographical characteristics of primary progressive multiple sclerosis in Isfahan, Iran.

Primary progressive multiple sclerosis (PPMS) is an uncommon form of multiple sclerosis (MS) in which the course of disease is progressive from onset. In a retrospective study amongst 1606 MS patients registered in Isfahan MS Society (IMSS) from April 2003 to 31 December 2005, 92 PPMS cases were identified. That means, the frequency of PPMS amongst all included MS patients would be 5.7% (95% CI: 6.7% and 4.7%). The mean expanded disability status scale (EDSS) for the group was 5.09 +/- 1.3. The commonest mode of presentation was motor disturbance in 55 (59.8%), other modes of presentation were…

[The possibilities of adaptation of patients with multiple sclerosis: the results of clinical and psychological study].

A complex clinical and psychological examination of three groups of patients with stable neurological deficit (113 subjects, 77 men and 76 women, aged from 19 to 67 years) included those with multiple sclerosis (MS), chronic cerebral vascular disorders and chronic dorsopathy with illness duration 5-7 years has been carried out. Neuropsychological status and quality of life were assessed using the following tests: Medical Outcomes Study Short Form 36 Health Survey (SF-36); the method of E.B. Fantalova "Level of Ratio of "Values" to "Availability" in Different Life Spheres", Integrative Anxiety …

Tumor-like manifestation, uncommon form of multiple sclerosis: report of a patient.

Multiple Sclerosis (MS) is a demyelinating disease of the central nervous system, characterised by focal neurological dysfunction with relapsing and remitting course. Acute widespread or tumor-like manifestation is one of the rare clinical variants and has poor prognosis. Here, the authors report a 36-year-old man who presented with left hemifacial and left hemibody anesthesia for one month. His symptoms gradually progressed MRI brain showed multiple large hypersignal intensity lesions in both right and left frontoparietal lobes, surrounding with brain edema. Brain biopsy showed perivenous inf…

Obstetric regional blocks for women with multiple sclerosis: a survey of UK experience.

BACKGROUND: There has been a reluctance to use regional blocks for women with multiple sclerosis as effects on the course of the disease are unclear. We assessed the views of UK consultant obstetric anaesthetists regarding management of women with multiple sclerosis. METHODS: Following Obstetric Anaesthetists' Association approval a questionnaire was sent to UK consultant members. Opinions were sought on antenatal assessment, labour analgesia, anaesthesia for elective and emergency caesarean section, and modification in technique for those with multiple sclerosis. Enquiries were made of postn…

Planned vaginal births in women with multiple sclerosis: delivery and birth outcome.

OBJECTIVE: The objective of this study was to investigate the effect of maternal multiple sclerosis (MS) on delivery and birth outcome in births without planned caesarean section. METHODS: Data were collected from the compulsory Medical Birth Registry of Norway from 1988 to 2002. Intended vaginal births in this time period were 449 births given by MS mothers and 851,060 control births. RESULTS: The MS mothers had a higher rate of induction of labour, and there was a strong trend for slower progression of second stage of labour and increased use of forceps. The MS group had lower birth weight…

Сопротивление инсулину, воспаление и когнитивирование болезни Альцгеймера: уроки множественного склероза.

Сопротивление инсулину (сокращенная способность инсулина стимулировать использование глюкозы) широко распространено в Северной Америке и Европе, где так много one треть всех пожилых людей страдают продромальным или клиническим типом 2 Болит диабет. Давно известно, что состояние инсулина отрицательно сказывается на общем состоянии здоровья. Растущий объем данных говорит о том, что инсулин способствует нормальному функционированию мозга и что периферийные инсулины повышают риск потери памяти и нейродегенеративных расстройств, таких как болезнь Альцгеймера. Потенциальные механизмы такого воздейст

Совпадение в аннотации оригинала
Insulin resistance (reduced ability of insulin to stimulate glucose utilization) is common in North American and Europe, where as many as on … work. An intriguing question is whether insulin abnormalities also influence the pathophysiology of multiple sclerosis (MS), an autoimmune disorder characterized by elevated inflammatory biomarkers, central nervous system white matter lesions, axonal degeneration, and cognitive impairment. MS increases the risk for type 1 diabetes mellitus. Furthermore, the lack of …

Prolonged duration of anesthesia in a patient with multiple sclerosis following paravertebral block.

PURPOSE: To explore the possibility that the prolonged duration of anesthesia following paravertebral block was related to the presence of multiple sclerosis in a patient undergoing elective inguinal hernia repair. CLINICAL FEATURES: A healthy 33-yr-old female presented for elective inguinal hernia repair. The procedure was performed under general anesthesia and a paravertebral block was performed at the end of the procedure for postoperative pain relief, whilst the patient was still anesthetized. Upon recovering from general anesthesia it was noted that the patient had a flaccid paralysis of…

The pathology of multiple sclerosis is the result of focal inflammatory demyelination with axonal damage.

Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system manifested morphologically by inflammation, demyelination, axonal loss and gliosis. The inflammatory lesions are characterized by massive infiltration by a heterogeneous population of cellular and soluble mediators of the immune system, including T cells, B cells, macrophages and mi croglia, as well as a broad range of cytokines, chemokines, antibodies, complement and other toxic substances. The appearance of such lesions is associated with clinical relapses. Recent detailed immunopathological stud…

[Therapy of pain syndromes in multiple sclerosis -- an overview with evidence-based recommendations].

While pain is a common problem in multiple sclerosis (MS) patients, it is frequently overlooked and has to be asked for actively. Pain can be classified into 4 diagnostically and therapeutically relevant categories. 1. PAIN DIRECTLY RELATED TO MS: Painful paroxysmal symptoms like trigeminal neuralgia or painful tonic spasms are treated with carbamazepine as first choice, or lamotrigine, gabapentin, oxcarbazepine and other anticonvulsants. Painful "burning" dysaesthesia, the most frequent chronic pain syndrome, are treated with tricyclic antidepressants or carbamazepine, further options include…

Lack of serum oligoclonal antibody responses to Chlamydophila pneumoniae in multiple sclerosis.

Chlamydophila pneumoniae has been proposed as an aetiological agent in MS via a mechanism involving molecular mimicry. We undertook to investigate whether the presence of CSF oligoclonal IgG OCB or oligoclonal bands correlated with serum IgG raised against C. pneumoniae. Paired serum and CSF of 19 MS patients and 27 control patients with other neurological diseases were studied by IEF and Western blotting. Only 1 of 19 MS patients had serum antibodies against C. pneumoniae compared with 2 of the 26 control patients. This was not significant, leading us to conclude that this study does not supp

Trigeminal neuralgia in a patient with multiple sclerosis and chronic inflammatory demyelinating polyneuropathy.

BACKGROUND: Trigeminal neuralgia (TN) is characterized by unilateral, severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the fifth cranial nerve. Symptomatic or secondary TN involves TN-like pain that develops owing to a central nervous system lesion (benign or malignant) or to multiple sclerosis (MS). CASE DESCRIPTION: The authors present a report of a unique case of a 43-year-old patient with unilateral TN, MS and concomitant chronic inflammatory demyelinating polyneuropathy. The facial pain preceded any other manifestations of the systemic disorders, and…

Exposure to infant siblings during early life and risk of multiple sclerosis.

CONTEXT: The "hygiene hypothesis" has implicated sibship as a marker of infection load during early life and suggests that exposure or reexposure to infections can influence the developing immune system. Viral infection has also been implicated in the pathogenesis of multiple sclerosis (MS). OBJECTIVES: To evaluate whether exposure to infant siblings in early life is associated with the risk of MS, and to explore the possible mechanism for any apparent protective effect, including altered Epstein-Barr virus (EBV) infection patterns. DESIGN, SETTING, AND PATIENTS: Population-based case-contro…