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[Painful tonic seizures in multiple sclerosis. Clinical and electromyographic aspects (author's transl)].

This case report deals with a 29 year-old female patient with a prior history of a vestibular syndrome and elapsing optic neuritis that presented paroxystic episodes of painful tonic contractions affecting the right hemibody, especially the upper limb. In the hand the clinical picture was similar to that of the carpal spasm of tetany. When inducing a crisis with ischemia the electromyogram showed diplets, triplets, and multiplets following the appearance of an interference pattern syncronous with contraction of the hand. Occasionally an interference pattern was observed that was associated onl

Single cell landscape of sex differences in the different courses of multiple sclerosis.

BACKGROUND: One of the major challenges in addressing multiple sclerosis is to understand its progression trajectory. The pathological process transitions from acute phases predominantly driven by inflammation to progressive clinical profiles where neurodegeneration takes precedence. It is known that sex plays a crucial role in this heterogeneity; females are two to three times more likely to suffer from multiple sclerosis, while males suffer from more rapid neurodegeneration with greater severity. RESULTS: To gain insight into the sex-based molecular differences, we processed single cell dat…

Efficacy and safety of tolebrutinib in multiple sclerosis: a systematic review and meta-analysis.

BACKGROUND: Tolebrutinib is an oral, brain-penetrant Bruton's tyrosine kinase (BTK) inhibitor being investigated for multiple sclerosis (MS). Early data point to reduced relapse rates and radiological disease activity, along with a reassuring safety profile. This systematic review and meta-analysis bring together the available evidence on its clinical efficacy and adverse events. METHODS: We searched PubMed, Web of Science, and Scopus through February 2026 using predefined eligibility criteria. Data were extracted on efficacy outcomes (disability progression and improvement, MRI activity, and…

Predictors of relapse following transition to ofatumumab in relapsing-remitting multiple sclerosis.

INTRODUCTION: Ofatumumab (OFA) is an emerging therapy for relapsing-remitting multiple sclerosis (RRMS), but the impact of prior disease-modifying therapy (pDMT) on outcomes after switching is unclear. OBJECTIVES: To evaluate predictors of first-year relapse after switching from selected pDMTs to OFA in adults with RRMS enrolled in the MSBase Registry. RESULTS: Among 866 patients (median EDSS 2.5), 10.5% experienced a relapse in the first year on OFA. Switching from fingolimod was associated with higher relapse risk compared to switching from injectable therapies (HR 1.89, 95% CI 1.03-3.44, …

Perceptual, patient-reported, and acoustic voice characteristics in individuals with multiple sclerosis.

PURPOSE: Voice impairment is increasingly recognised as a relevant but often underexplored feature of multiple sclerosis (MS). The present study aimed to investigate vocal characteristics in individuals with MS using a combined subjective, perceptual, and acoustic assessment approach. METHODS: A total of 91 participants were included, comprising 48 individuals with MS and 43 healthy controls. Vocal function was assessed using the Voice Handicap Index (VHI), the GRBAS perceptual scale, and acoustic analysis of sustained phonation, including fundamental frequency (fo), jitter, shimmer, and harm…

Altered Glutamate Homeostasis in Paramagnetic Rim Lesions of Patients with Multiple Sclerosis.

Paramagnetic rim lesions are a subset of focal white matter lesions specific to multiple sclerosis that are chronically inflamed and are associated with increased tissue injury, brain atrophy, and clinical disability. The molecular mechanisms linking paramagnetic rim lesions to these progressive biological outcomes remain unclear. Glutamatergic dysregulation has been hypothesized as a mechanism of multiple sclerosis progression potentially via excitotoxicity, but lesion-specific involvement is unknown. Here, 7T MRI was used to investigate glutamate-related metabolic alterations in paramagnetic…

The efficacy of surgical interventions for trigeminal neuralgia in multiple sclerosis: A systematic review.

Trigeminal neuralgia affects approximately 3% of patients with multiple sclerosis - a far higher prevalence than in the general population. The associated pain often proves refractory to medication, prompting consideration of neurosurgical intervention. The variable efficacy, tolerability, and durability of available procedures, compounded by factors such as multiple sclerosis subtype and neuroimaging findings, require evidence to guide personalised surgical decision-making. This systematic review evaluates surgical interventions for trigeminal neuralgia in multiple sclerosis, analysing how pa…

Диссоциация утомляемости и утомимости при многоразовом склерозе: роль когнитивной скорости обработки.

Усталость у людей с множественным склерозом (PwMS) является распространенной и невыносимой, но плохо понимаемой. Цель этого исследования заключалась в том, чтобы уточнить различие между долгосрочной усталостью и жироспособностью, обусловленной выполнением задач, и их соответствующими патофизиологическими процессами, а также изучить вклад снижения скорости когнитивной обработки (КПС) в взаимосвязь между структурным повреждением мозга, усталостью и жироспособностью. МЕТОДЫ: Усталость была вызвана 34 PwMS (PwMS)18-49 годы) и 32 контроля за здоровым состоянием здоровья (НС, 24-44 ) с использование

Совпадение в аннотации оригинала
BACKGROUND: Fatigue in people with multiple sclerosis (PwMS) is common and disabling, yet poorly understood. This study aimed to clarify the distinction between long-term fatigue and task-induced fatigability and their respective pathophysiological processes, and to examine the contribution of decreased cognitive processing speed (CPS) to the relationship be…

Patterns of Multimorbidity in Persons with Multiple Sclerosis: Belgrade Population Registry Data.

INTRODUCTION: Multimorbidity was defined as having at least two comorbidities in addition to the confirmed index diagnosis. The aim of the present study was to determine multimorbidity patterns in patients with multiple sclerosis (PwMS) from the Belgrade region, using population-based MS Registry data. Additionally, comparison of the prevalence of multimorbidity in PwMS and in the general population of Serbia was also performed. METHODS: The source for this study was Belgrade population-based MS Registry, established and maintained at the Clinic of Neurology, University Clinical Center of Ser…

Violence and multiple sclerosis: Towards an evidence-informed call to action in neurology.

Violence is a global health concern with profound physical, psychological and social consequences. People with multiple sclerosis (MS) may experience sustained risk due to the intersection of chronic illness, disability, gendered dynamics and structural inequality. MS-specific evidence remains limited and methodologically heterogeneous, precluding reliable conclusions regarding prevalence, outcomes or health system responses. Nonetheless, emerging findings, alongside broader disability literature, indicate that violence is relevant to MS care. This review situates MS within international evide…

A real-world study on persistence with ofatumumab in Canadian patients with multiple sclerosis.

BACKGROUND: In multiple sclerosis, disease-modifying therapies aim to reduce relapse rate and slow disease progression. An important component of successful disease control is treatment persistence, which is the time a patient remains on a therapy. The primary objective of this study was to examine persistence with ofatumumab in a real-world setting. METHODS: This was a retrospective cohort study using data from the Patient Support Program (clinicaltrials.gov number NCT06854341). Adults diagnosed with relapsing remitting multiple sclerosis who initiated ofatumumab were included. Persistence, …

The evolution of disease criteria in multiple sclerosis: underlying motives and broader implications.

INTRODUCTION: Disease criteria for multiple sclerosis (MS) have changed significantly over the past three decades. The development of biomarkers, particularly MRI, has played an essential role in this process. These changes can lead to several broader implications, which are not always intended or recognized. However, they can have a major impact on patients, healthcare and society. We investigated the changing disease criteria, explored the underlying motives and discuss their implications. METHODS: We identified all publications on MS diagnostic criteria between 1983 and 2024. Through conve…

Multiple sclerosis and the risk of dementia: a real-world, nationwide cohort study.

BACKGROUND: Multiple sclerosis (MS) is a chronic autoimmune and neurodegenerative disease that often causes cognitive impairment. This study aimed to investigate the association between MS and the risk of dementia in a large, nationwide Taiwanese cohort and to examine the potential impact of Disease-modifying drugs (DMDs) on the dementia incidences. METHODS: We conducted a population-based cohort study using Taiwan's National Health Insurance Research Database (NHIRD) between 2000 and 2015. Adults aged ≥20 years with a diagnosis of MS (n = 10,525) were matched 1:3 by age, sex, index date, and…

A National Danish Effectiveness Study of Ocrelizumab Versus Natalizumab in Multiple Sclerosis.

BACKGROUND: Ocrelizumab and natalizumab are highly effective disease-modifying treatments for relapsing-remitting multiple sclerosis (RRMS). Direct comparison of effectiveness is crucial for optimizing treatment decisions and improving patient outcomes. The aim was to compare any difference in effectiveness of ocrelizumab and natalizumab on disease activity and progression in RRMS. METHODS: This was a national multicenter comparative effectiveness research study using data from the nationwide population-based registry of MS cases in Denmark. Patients were included from January 2018 to April 2…

Incidence of multiple sclerosis in UK general practice; Risk of infections and mortality.

Multiple sclerosis (MS) is a leading cause of severe neurological disability and is associated with substantial comorbidity. Infections represent a major complication, and patients with MS have an increased risk of mortality. This population-based descriptive cohort study examined the natural history of MS in general practice, focusing on incidence, comorbidities, infection risk, and mortality. Patients with incident MS between 2000 and 2016 were identified from the Clinical Practice Research Datalink (CPRD) and compared with a matched cohort from the general population. Incidence rates, assoc…

Neurofilament Light Chain Concentration in the Prediction of Treatment Response in Multiple Sclerosis.

INTRODUCTION: Management of multiple sclerosis (MS) revolves around timely initiation of effective disease-modifying therapy. Here we investigate the additive predictive value of age-adjusted normalised neurofilament light chain (NfL) concentrations when combined with a clinicodemographic model of treatment response. METHODS: Data were obtained from three sources: the University Hospital Basel, the SET cohort in Prague, and EIMS and IMSE cohorts from Sweden. NfL samples were collected within 90 days of baseline, age-adjusted and normalised using a reference population. Principal component ana…

Empowering yet challenging: managing multiple sclerosis in the workplace-an interview study.

BACKGROUND: Having a chronic disease such as multiple sclerosis (MS) may pose challenges for affected individuals in their work life. Given its progressive nature and wide range of symptoms, living with MS requires ongoing adaptation. In addition to work accommodations and support, individuals may develop their own strategies to manage their condition at work. OBJECTIVES: To explore experiences of people with MS (PwMS) in managing MS in the workplace, focusing on strategies they employ to facilitate their work lives and challenges they navigate. METHODS: Semi-structured individual interviews…

The effect of cladribine tablets on intrathecal inflammation in relapsing-remitting multiple sclerosis.

BACKGROUND: To investigate the intrathecal effect of cladribine tablets on cerebrospinal fluid (CSF) inflammatory proteomic profile, cortical lesions (CLs), paramagnetic rim lesions (PRLs) number and cognition after 2 years of treatment. RESULTS: Forty-two patients with RRMS treated with cladribine tablets were enrolled in a prospective longitudinal 2-year study. All patients were scheduled to undergo a lumbar puncture before treatment initiation and after 2 years of treatment, a clinical evaluation, including Expanded Disability Status Scale (EDSS) assessment, every 6 months, and a 3T MRI eve