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Treatment of Multiple Sclerosis.

OBJECTIVE: This article addresses the evidence basis for treating acute multiple sclerosis (MS) relapses and choosing disease-modifying therapies in patients with relapsing MS, radiologically isolated syndrome, and progressive MS. LATEST DEVELOPMENTS: Symptoms related to MS relapses occur as a result of new acute focal inflammatory demyelination and may improve more quickly with the use of high-dose corticosteroids. However, these treatments must not be given when symptoms are instead due to systemic issues (eg, non-neurologic illness, sleep deprivation, infection) that lead to transient wors…

Cognition in multiple sclerosis.

PURPOSE OF REVIEW: Cognitive dysfunction in multiple sclerosis (MS) has gained increasing attention over recent decades, reflecting its substantial effects on day-to-day functioning and the limited availability of targeted therapies. This review addresses contemporary advances in the role of cognition to detect disease progression, examines biological and MRI correlates of cognitive dysfunction, and summarizes the evidence for treatment effects. RECENT FINDINGS: Cognitive changes can capture both acute relapse-related drops (including isolated cognitive relapses) and gradual decline consisten…

Advances in Multiple Sclerosis.

Multiple sclerosis is a chronic autoimmune disorder that affects the central nervous system, causing episodes of neurologic dysfunction and often gradual disease progression. The immune system primarily targets myelin, the protective covering of nerve fibers, leading to inflammation and damage, and secondary neurodegeneration is a major cause of long-term disability. Common symptoms include vision problems, sensory disturbances, muscle weakness, balance difficulties, and bladder dysfunction. Important advances in treatment have improved outcomes in patients with relapsing forms of multiple scl…

Natalizumab for multiple sclerosis.

RATIONALE: Natalizumab (NTZ) is the first monoclonal antibody approved for the treatment of highly active relapsing-remitting multiple sclerosis (RRMS). Since 2010, several new studies on NTZ for MS have emerged. OBJECTIVES: To evaluate the benefits and harms of NTZ alone or associated with other treatments in people with any form of MS. SEARCH METHODS: We searched CENTRAL, PubMed, Embase, and two trials registries together with reference checking and contact with study authors to identify studies for inclusion in the review. The latest search date was 1 February 2024. ELIGIBILITY CRITERIA:…

Обновить в нескольких склерозах.

Множественный склероз (MS) — хроническое демиелионирующее расстройство центральной нервной системы (CNS), которое затрагивает главным образом пациентов в возрасте 20-40 лет. Эпидемиология MS меняется во всем мире, как и понимание ее иммунопатогенеза и естественной истории, с новыми свидетельствами, указывающими на многофакторную этиологию, охватывающую как экологические, так и генетические факторы. За последние несколько десятилетий показатели распространенности и распространенности НР во всем мире неуклонно возрастали. Диагностика MS основана на учете результатов клинических и параклинических

Совпадение в аннотации оригинала
Multiple Sclerosis (MS) is a chronic demyelinating disorder of the central nervous system (CNS) that affects predominately patients aged 20-40 years. The epidemiology of MS is changing worldwide, as is the understanding of its immunopathogenesis and natural history, with new evidence pointing towards a multifactorial etiology involving both environmental and…

Улучшения в множественном склерозе.

Растет глобальная распространенность множественного склероза (MS), а ранняя диагностика и лечение имеют важное значение для смягчения последствий инвалидности. Несмотря на то, что в последнее время терапевтические достижения привели к значительному сокращению числа рецидивов, прогрессивные и дегенеративные аспекты НР по-прежнему создают серьезные проблемы. Обновление в этом году диагностических критериев McDonald направлено на повышение чувствительности и содействие более раннему использованию методов лечения асимптоматических заболеваний. Кроме того, новые биомаркеры получат развитие в клинич

Совпадение в аннотации оригинала
The global prevalence of multiple sclerosis (MS) is increasing, and early diagnosis and treatment is essential in mitigating disability. While recent therapeutic advancements have significantly reduced relapse rates, the progressive and degenerative aspects of MS continue to pose major challenges. This year updates to the McDonald diagnostic criteria aim to …

Множественный склероз и эпилепсия.

Эпилепсия является заметным коморбидом в множестве склерозов (MS), причем ее распространенность значительно выше, чем у населения в целом. Это сопровождение предполагает наличие общих патофизиологических механизмов, включая кортикальное обезвоживание, хроническое воспаление и нейродегенерацию, которые предрасположены пациентов к припадкам MS. Углубленные съемочные исследования подчеркивают роль корковых повреждений и атрофии в эпилептогенезе, в то время как подстрекательские процессы еще более снижают пороговый уровень изъятия. Кроме того, дисфункция сети, связанной с MS, нарушает нормальную н

Совпадение в аннотации оригинала
Epilepsy is a notable comorbidity in multiple sclerosis (MS), with a prevalence significantly higher than in the general population. This co-occurrence suggests shared pathophysiological mechanisms, including cortical demyelination, chronic inflammation and neurodegeneration, which predispose MS patients to seizures. Advanced imaging studies highlight the ro…

Гипоксия в множестве склерозов.

Низкая доступность кислорода (гипоксии) является заметной, но плохо понимаемой особенностью множественного склероза (МС). Неизвестно, вызывает ли гипоксия патологию и симптомы MS или она является следствием других патологических явлений, таких, как воспаление и сосудистая дисфункция. Здесь мы резюмируем имеющуюся литературу о взаимосвязи между гипоксией и как патологическими, так и симптомными характеристиками MS. Острая экологическая гипоксия (т.е. высота) может вызвать или облегчить события, связанные с MS, возможно, путем усиления гипоксии тканей в центральной нервной системе. Соответственн

Совпадение в аннотации оригинала
Low oxygen availability (hypoxia) is a prominent but poorly understood feature in multiple sclerosis (MS). Whether hypoxia causes or drives MS pathology and symptoms or whether it is a consequence of other pathological events, such as inflammation and vascular dysfunction, is unknown. Here, we summarize the available literature on the interplay between hypox…

[Treatment of multiple sclerosis].

Multiple sclerosis is a chronic inflammatory disease of the central nervous system, caused by an autoimmune reaction. Treatment options have largely increased over the years. In this article, we present two clinical cases. Patient A has a classic relapsing remitting course of multiple sclerosis with satisfactory effect on second line therapy. Patient B had a stable disease course until a new relapse occurred after the initiation of TNF-alpha blocking therapy because of Crohn's disease. The co-occurrence of multiple auto-immune diseases creates challenges, but also opportunities in choosing the…

Alemtuzumab for multiple sclerosis.

BackgroundMultiple sclerosis (MS) is an autoimmune, T-cell-dependent, inflammatory, demyelinating disease of the central nervous system, with an unpredictable course. Current MS therapies focus on treating and preventing exacerbations, and avoiding the progression of disability. At present, there is no treatment that is capable of safely and effectively reaching these objectives. Clinical trials suggest that alemtuzumab, a humanized monoclonal antibody, could be a promising option for MS.ObjectivesTo evaluate the benefits and harms of alemtuzumab alone or associated with other treatments in pe…

[Multiple sclerosis and melanoma].

Multiple sclerosis (MS) is a chronic autoimmune progressive demyelinating disease of the central nervous system, mainly in young people. The clinical picture of MS has a variety of neurological symptoms, which manifests itself during periods of exacerbation or progression and stabilizes at the moments of remission. The widespread introduction of new drugs with immunosuppressive and immunomodulatory mechanisms of action has led to the development of special risk management plans for monitoring patients during therapy and preventing adverse events and new comorbid conditions. This article presen…

[Multiple sclerosis and pregnancy].

"Pregnancy and multiple sclerosis Pregnancy is a possibility for a patient with multiple sclerosis, but it is best to anticipate and plan for it. Pregnancy does not worsen the disability in the long term. The risk of relapse in the 3 months postpartum depends on the risk of relapse in the year preceding the pregnancy; it is therefore preferable to plan a pregnan¬cy when the multiple sclerosis is stabilized. The main¬tenance of background treatment in preconception or during pregnancy depends on the type of medication, the risk for the child (miscarriage, malformations) but also the risk of reb…

Neuromodulation in multiple sclerosis.

Neuromodulation, or the utilization of advanced technology for targeted electrical or chemical neuronal stimulation or inhibition, has been expanding in several neurological subspecialties. In the past decades, immune-modulating therapy has been the main focus of multiple sclerosis (MS) research with little attention to neuromodulation. However, with the recent advances in disease-modifying therapies, it is time to shift the focus of MS research to neuromodulation and restoration of function as with other neurological subspecialties. Preliminary research supports the value of intrathecal baclo…

Vaccines and multiple sclerosis.

An association between certain vaccinations and onset or relapse of multiple sclerosis (MS) has been debated. Based on PubMed, we made a thorough literature review and included all relevant studies, 51 on MS and 15 on optic neuritis (ON). Case studies were excluded. With the exception of a live vaccine against yellow fever, vaccinations appear safe in untreated patients with MS and ON. However, most studies were underpowered, and small risks cannot be excluded. One study of BCG vaccination after the first demyelinating event showed even a reduced risk of developing MS. Further studies are need…

Alemtuzumab for multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is an autoimmune, T-cell-dependent, inflammatory, demyelinating disease of the central nervous system, with an unpredictable course. Current MS therapies focus on treating exacerbations, preventing new exacerbations and avoiding the progression of disability. However, at present there is no effective treatment that is capable of safely and effectively reaching these objectives. This has led to the development and investigation of new drugs. Recent clinical trials suggest that alemtuzumab, a humanised monoclonal antibody against cell surface CD52, could be a …

Vaccines in Multiple Sclerosis.

Vaccinations help prevent communicable disease. To be valuable, a vaccine's ability to prevent disease must exceed the risk of adverse effects from administration. Many vaccines present no risk of infection as they are comprised of killed or non-infectious components while other vaccines consist of live attenuated microorganisms which carry a potential risk of infection-particularly, in patients with compromised immunity. There are several unique considerations with respect to vaccination in the multiple sclerosis (MS) population. First, there has been concern that vaccination may trigger or a…

Aspirin and multiple sclerosis.

Aspirin is widely used to lessen the risks of cardiovascular events. Some studies suggest that patients with multiple sclerosis have an increased risk for some cardiovascular events, for example, venous thromboembolism and perhaps ischemic strokes, raising the possibility that aspirin could lessen these increased risks in this population or subgroups (patients with limited mobility and/or antiphospholipid antibodies). However, aspirin causes a small increased risk of hemorrhagic stroke, which is a concern as it could potentially worsen a compromised blood-brain barrier. Aspirin has the potenti…