Prediction of Conversion from Clinically Isolated Syndrome to Multiple Sclerosis According to Baseline Characteristics: A Prospective Study

Objective: Clinically isolated syndrome (CIS) is a clinical state that proceeds with inflammation and demyelination, suggestive of multiple sclerosis (MS) in the central nervous system in the absence of other alternative diagnoses. The purpose of this study was to determine in a prospective cohort, the predictor factors in conversion from CIS to MS on the basis of clinical, magnetic resonance (MR) imaging and cerebrospinal fluid (CSF) findings

Evaluation of clinical parameters during and after treatment of attack in patients with clinically isolated syndrome: Comparison of the results with that of multiple sclerosis patients

Objectives: The aim of the present study was to examine the changes in the measurement of functions during and after pulse methylprednisolone (MP) treatment during a clinically isolated syndrome (CIS) attack, using the multiple sclerosis functional composite (MSFC) and Expanded Disability Status Scale (EDSS), and to compare the results with that of MS patients

An evaluation of the relation between atrial fibrillation and smoking in patients undergoing stroke

Aim and objective Atrial fibrillation (AF) occupies an important place among the etiological agents in ischemic cerebrovascular disease. Smoking is thought to be a predisposing factor for AF. The probable relation between smoking and AF can be explained in terms of oxidant mechanisms and inflammation. This study investigated the probable link between smoking and AF against a background of stroke. Methods Three centers were included in the study. Cases diagnosed with stroke and transient ischemic attack (TIA) arriving at these centers were evaluated in terms of demographic, clinical, and radiological characteristics. The Modified Rankin Score (MRS) and National Institutes of Health Stroke Scale (NIHSS) scores were used to assess severity of stroke. Results Three hundred forty-one patients with a mean age of 73.73±11.40 were enrolled; 282 were evaluated as ischemic stroke, 50 as hemorrhagic stroke, and 9 as TIA. Mean MRS was 2.92±1.63, and mean NIHSS was 10.12±8.01. Of the study group, 65.7% had never smoked, 23.2% were active smokers, and 11% had quit. The relation between etiological factors and smoking was investigated based on the TOAST classification in the ischemic subgroup. Stroke associated with large or small vessel disease and the AF-related stroke group were compared in terms of smoking status, and smoking status was significantly higher in the AF group (p=0,04). A significant difference was observed in mean EF values at echocardiography performed on patients in the ischemic subgroup between the smoking and non-smoking groups (57.71±14.37, and 60.83±8.92, respectively, p=0,002). Conclusions Our study determined no relation between smoking and stroke subtypes, severity, or other risk factors, while smoking emerged as a risk factor in AF-related stroke. This once again shows that smoking, in other words nicotine, lays the foundation for AF through inflammation, catecholamine-mediated effects, and oxidative stress, constitutes a risk factor for stroke, together with advanced age

A Rare Cause of Cerebral Venous Thrombosis: Essential Thrombocytosis

Introduction: Essential thrombocytosis (ET) is a myeloproliferative disease ongoing with megakaryocytic hyperplasia in bone marrow and with an increased risk of both bleeding and thrombosis. Macro- and microvascular events can be seen in ET. Macrovascular events are frequently arterial, and less commonly venous

Narrative review based on fingolimod therapy in pediatric MS

The course of pediatric-onset multiple sclerosis and adult multiple sclerosis shows some clinical differences. The rate of having a second attack after the first clinical event is 80% in children and around 45% in adults but the time to the second event is similar in all age groups. The pediatric group usually has a more aggressive onset than adults. On the other hand, a higher rate of complete recovery is observed in pediatric-onset multiple sclerosis after the first clinical event compared to the adult group. Despite a highly active initial disease course, pediatric-onset multiple sclerosis patients show a slower increase in disability than patients with adult-onset disease. This is thought to be due to greater remyelination capacity and plasticity of the developing brain. The management of pediatric-onset multiple sclerosis includes safety issues as well as effective disease control. In the pediatric-onset multiple sclerosis group, similar to adult multiple sclerosis, injectable treatments have been used for many years with reasonable efficacy and safety. Since 2011, oral treatments and then infusion treatments have been approved and used effectively in adult multiple sclerosis and have gradually entered clinical use in the pediatric-onset multiple sclerosis group. However, clinical trials are fewer, smaller, and include shorter follow-up due to the much lower prevalence of pediatric-onset multiple sclerosis than adult multiple sclerosis. This is particularly important in the era of recent disease-modifying treatments. This review of the literature presents existing data on the safety and efficacy of fingolimod, pointing to a relatively favorable profile

Cognitive dysfunction in patients with multiple sclerosis treated with first-line disease-modifying therapy: a multi-center, controlled study using the BICAMS battery

Multiple sclerosis (MS) can impair cognitive functions even in the early stages. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery is very short and highly sensitive and can be used to evaluate cognitive status in the disease. Several clinical trials have shown beneficial effects of disease-modifying drugs (DMDs) on long-term cognitive measures which may even reduce cognitive deficits in MS patients. Relapsing remitting MS patients using DMDs were enrolled in the study and monitored for 12 months. BICAMS and the Expanded Disability Status Scale were applied to the study group. We evaluated and monitored 161 newly diagnosed cases of definite MS by the end of the trial. 110 patients (68.2%) were female. One hundred and two healthy subjects (female to male ratio 68:34) were enrolled into the study. MS patients were categorized into three DMT groups: IFNB1-a SC, IFNB1-b, and GA. Mean scores of all three cognitive tests (SDMT, BVMT-R, and CVLT-II) were significantly higher in the control group than in the MS patients. The number of cognitively impaired patients decreased from 31.7 to 21.7% on the basis of CVLT (p = 0.024), and 42 (26.1%) to 30 (18.6%) on the basis of BVMT-R at month 12. A significant difference was determined in terms of cognitive status between MS patients using both IFNB and GA and the healthy control group. Ours is the first study to compare IFNB and GA in terms of evaluating cognitive involvement and to use the BICAMS battery in monitoring treatment

Effects of Fingolimod on Cognitive Status in Patients with Multiple Sclerosis: Prospective, Controlled Trial

68th Annual Meeting of the American-Academy-of-Neurology (AAN) -- APR 15-21, 2016 -- Vancouver, CANADAWOS: 000411279008121…Amer Acad Neuro

Lentiform fork sign in a diabetic uremic patient: pathophysiology is still not clear

50th Turkish National Neurology Congress -- NOV 21-27, 2014 -- Antalya, TURKEYWOS: 000484316100007Neurological disorders observed in end stage renal disease (ESRD) other than clouding of consciousness, involuntary movements and uremic encephalopathy capable of causing seizures include wakefulness defect caused by effects on basal ganglia associated with metabolic acidosis, movement disorder and, independent of these, progressive cognitive impairment of insidious onset. A 57-year-old male patient was started on hemodialysis (HD) with a diagnosis of ESRD secondary to diabetic nephropathy 5 months ago while under monitoring for diabetes mellitus and hypertension known for the previous 10 years. The patient presented to our hospital emergency service due to clouding of consciousness, wakefulness defect and lack of appetite that had begun 2 days ago. Computed tomography (CT) and diffusion magnetic resonance imaging (MRI) of the brain were performed during assessment in the emergency department. CT of the brain revealed symmetrical hypodensity in bilateral basal ganglia. Diffusion MRI of the brain revealed diffusion restriction not accompanied by hypointensity on apparent diffusion coefficient images in bilateral lentiform nucleus. Mannitol therapy was tapered and discontinued on day 3. The patient was enrolled on a 3-times-weekly HD program. Although the pathophysiology of lentiform fork sign (LFS) is still not fully clear, in our case, LFS may have developed due to insufficient dialysis and consequent metabolic acidosis and uremia. We report this case due to the rarity of LFS.Turkish Neurol So

The neuroprotective effect of erythropoietin on experimental Parkinson model in rats

WOS: 000350935400001PubMed ID: 25464888Dopaminergic neuronal loss in Parkinson's disease (PD) results from oxidative stress, neuroinflammation and excitotoxicity. Because erythropoietin (EPO) has been shown to have antioxidant, anti-inflammatory and neuroprotective effects in many previous studies, present study was designed to evaluate the effect of EPO on rotenone-induced dopaminergic neuronal loss. The rats in which PD was induced by stereotaxical infusion of rotenone showed increased MDA and TNF-alpha levels and decreased HVA levels. On the other hand, EPO treatment resulted in markedly decreased MDA and TNF-alpha levels and increased HVA levels. EPO treatment in rotenone-infusion group resulted in improvement of striatal neurodegeneration and a significant increase in decreased total number of neurons and immunohistochemical TH positive neurons. Results of the present study demonstrate the neuroprotective, anti-inflammatory and antioxidant effects of EPO in a rotenone-induced neurodegenerative animal model. (C) 2014 Elsevier Ltd. All rights reserved

Intrathecal IgM production correlates with more severe disease course in multiple sclerosis: Clinical and MRI results

12th International Congress of Neuroimmunology (ISNI) -- NOV 09-13, 2014 -- Mainz, GERMANYWOS: 000345192100029