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There have been reports of central nervous systemic inflammatory disease associated with vaccination. We describe a female patient who developed longitudinally extensive transverse myelitis following seasonal influenza vaccination. A 38-year-old woman had severe neck and back pain with urinary retention. She received influenza vaccine 3 days before symptom onset. Examination revealed mild quadriparesis with diffuse hyperreflexia. Magnetic resonance imaging (MRI) of the spine showed a T2 hyperintense lesion ...
Tolerability, treatment satisfaction and quality of life outcomes in stable multiple sclerosis patients switched from injectable therapies to auto injected intramuscular interferon beta 1a: The SFERA study.
Interferon beta (IFNB) and Glatiramer acetate, long-term first line disease modifying treatments (DMTs) for multiple sclerosis (MS), have different injection frequencies crucial for injection site related side effects. We aimed at investigating whether switching to intramuscular IFNB-1a injected once/week with the Avonex®Pen™ device improves treatment tolerability and quality of life in stable MS patients.
Although the expanded disability status scale (EDSS) is the most commonly used measure of disability for multiple sclerosis, measurement of disability accumulation is complex due to the unequal steps of the scale.
Neuromyelitis Optica (NMO) is an autoimmune astrocytopathic disorder due to AQP4 antibodies.
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis that presents potential impairment of the central nervous system (CNS). Frequent CNS impairment makes ECD a disease worth considering in the differential diagnosis of multiple sclerosis (MS). We report the case of a patient initially diagnosed with relapsing-remitting MS with an atypical course who developed ECD during the disease progression. Given the patient's clinical-radiological characteristics, two diagnostic possibilit...
Multiple Sclerosis (MS) is a neurodegenerative and inflammatory disease that impacts both visual and postural control. It is currently unknown how the integration between visual and postural control is affected in people with MS (PwMS). It has been shown in healthy individuals that saccadic eye movements can decrease body sway as result as the integration of eye and postural movements.
Multiple sclerosis (MS) is a leading cause of disability in adults and requires lifelong treatment. Specialty drugs referred to as disease-modifying therapies (DMTs) have become the standard for multiple sclerosis treatment since the 1990s as they have been shown to reduce the risk of relapses and to delay disease progression. While more DMTs became available, prices of DMTs including existing drugs continue to rise and remain very expensive. This study is to estimate recent drug costs for DMTs and examine ...
Multiple Sclerosis (MS) is a potentially progressive autoimmune disorder of the central nervous system. The pathology of MS is characterized by inflammation, demyelination, reactive gliosis and neuronal damage. Salusin-α and salusin-β have been shown to be widely expressed in many tissues, including the central nervous system. In our study, we investigated whether salusin-α and salusin-β peptides had a relation with inflammation and whether it is related to Relapsing-Remitting Multiple Sclerosis (RRMS) ...
Cerebrospinal fluid (CSF) kappa free light chains (KFLC) have been suggested as quantitative alternative to oligoclonal bands (OB) in multiple sclerosis (MS) diagnosis. Despite OB have been associated to poor disease prognosis, little is known on KFLC in predicting MS early progression. Our aim is to evaluate the prognostic value of KFLC in a cohort of Italian MS patients.
Suspected bacterial meningoencephalomyelitis as the presentation or trigger of neuromyelitis optica spectrum disorders (NMOSD) flare has not been reported in literature.
Patients afflicted with rare diseases often have a delay in diagnosis and treatment. Understanding the prevalence and impact of delayed diagnosis in transverse myelitis could trigger directed educational initiatives to increase clinician awareness and improve care.
Fabry's disease is an X-linked disorder of enzyme alpha-galactosidase A which leads to an accumulation of the glycolipids in lysosomes in vessels and organs. The disorder is rare with an estimated incidence of 1 in 40,000 and disease occurs more rarely in women than men. Paresthesias, hearing loss, and stroke are the typical neurological manifestations. Brain magnetic resonance imaging abnormalities may mimic those seen in multiple sclerosis (MS). Reported here is one of the rarely reported cases of Fabry's...
We report a 60-year-old male with anti-myelin oligodendrocyte glycoprotein (MOG) antibody who developed progressive cognitive deterioration and behavioral changes, with no other focal signs, over 9 months. MRI showed numerous T2-hyperintense lesions with partial contrast enhancement in white and grey matter of cerebrum, cerebellum and spinal cord. A brain biopsy revealed perivascular inflammatory cell infiltration, disturbed vascular continuity and no demyelination, indicative of a lymphocytic pattern of pr...
Multiple Sclerosis (MS) specialists routinely evaluate misdiagnosed patients, or patients incorrectly assigned a diagnosis of MS. Misdiagnosis has significant implications for patient morbidity and healthcare costs, yet its contemporary incidence is unknown. We examined the incidence of MS misdiagnosis in new patients referred to two academic MS referral centers, their most common alternate diagnoses, and factors associated with misdiagnosis.
The aim of the current study was to examine intra-family phenotype variations in familial neuromyelitis optica (NMO) spectrum disorder.
Numerous factors can affect multiple sclerosis (MS) patients' quality of life (QoL). We investigated how physical impairment, upper extremity function, cognitive impairment, cognitive reserve, symptoms of psychological distress, depression, fatigue as well as age and disease duration contribute to patient-reported measures of QoL in relapse-remitting MS (RRMS) and progressive MS (PMS).
Differential treatment allocation may impact on clinical phenotype in MS and in turn upon quality of life (QoL).
To evaluate the impact of a single day of protective stepping practice in individuals with Multiple Sclerosis (MS).
The clinical manifestation of multiple sclerosis (MS) is highly variable. Factors influencing phenotypic heterogeneity are not well known since most studies have relied on the Expanded Disability Status Scale which has modest inter/intra-rater reliability. We therefore sought to investigate other reliable and valid measures of impairment.
The number of white matter lesions (WML) in brain MRI is the most established paraclinical tool to support the diagnosis of multiple sclerosis (MS) and to monitor its course. Diagnostic criteria have stipulated a minimum detectable diameter of 3 mm per WML, although this threshold is not evidence-based. We aimed to provide a rationale for a WML size threshold for three-dimensional MRI sequences at 3 T by comparing patients with relapsing-remitting MS (RRMS) to control subjects (CS).
Multiple sclerosis (MS) is a chronic autoimmune disease of CNS with a highly heterogeneous clinical course. The role of the genetic variability in determination of MS course is not yet well established. We aimed to estimate the impact of immune-related genes variability in the genetic architecture of two clinically different MS courses - primary progressive (PPMS) and relapsing-remitting (RRMS).
Despite the multitude of rehabilitation interventions targeting gait impairments in persons with multiple sclerosis (PwMS), only little is known about the relative association of muscle strength and balance on different gait outcomes.
Despite having a high rate of occurrence, erythroblast appearance in peripheral blood may not be a recognized adverse effect of natalizumab (NTZ) treatment. Additionally, the time course and cause of erythroblast appearance remain unclear. We report two cases of multiple sclerosis wherein NTZ treatment led to erythroblast appearance in peripheral blood. Erythroblasts appeared after NTZ administration; however, their counts did not increase and the administration of medication was continued. NTZ can inhibit ...
Social cognition (SC) can be impaired in multiple sclerosis (MS) patients; however, most studies have not controlled for generalized cognitive impairment (CI), nor have they examined the role of the amygdala using advanced structural neuroimaging. Whether deficits in SC occur in the disease even before the concomitant manifestation of CI, with a specific interest in the role of bilateral amygdala.
To assess the distribution of nine hole peg test (9-HPT) and its clinical correlates in a large sample of patients with multiple sclerosis (MS).