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https://www.readbyqxmd.com/read/28337062/successful-treatment-of-beh%C3%A3-et-s-uveitis-with-tocilizumab
#1
F Alokaily, A Al Saati, A Jawad
A 33-year-old man with history of lymphoma was misdiagnosed as multiple sclerosis (MS) 18 months previously, developed intermediate uveitis, unresponsive to interferon, and corticosteroids. A diagnosis of Behçet's disease (BD) was made on the basis of recurrent orogenital ulceration, erythema nodosum, and a positive pathergy test. The patient was started on Tocilizumab and experienced an improvement in visual acuity and intraocular inflammation over the following 2 weeks. In patients with BD-related uveitis, Tocilizumab can be an effective alternative to anti-tumor necrosis factor alpha medications...
January 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28335743/reasons-for-discontinuation-of-subcutaneous-interferon-%C3%AE-1a-three-times-a-week-among-patients-with-multiple-sclerosis-a-real-world-cohort-study
#2
Meritxell Sabidó-Espin, Rick Munschauer
BACKGROUND: Continuation of interferon (IFN) β-based therapies is important for maximum treatment effectiveness in patients with multiple sclerosis (MS); however, few real-world data are available on discontinuation from IFN β. The aim of this cohort analysis was to estimate real-world discontinuation rates up to 3 years among MS patients in the United States taking subcutaneous (sc) IFN β-1a three times a week (tiw) and to identify whether the factors associated with discontinuation change over time...
March 23, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28334875/white-matter-changes-in-paediatric-multiple-sclerosis-and-monophasic-demyelinating-disorders
#3
Giulia Longoni, Robert A Brown, Parya MomayyezSiahkal, Colm Elliott, Sridar Narayanan, Amit Bar-Or, Ruth Ann Marrie, E Ann Yeh, Massimo Filippi, Brenda Banwell, Douglas L Arnold
Most children who experience an acquired demyelinating syndrome of the central nervous system will have a monophasic disease course, with no further clinical or radiological symptoms. A subset will be diagnosed with multiple sclerosis, a life-long disorder. Using linear mixed effects models we examined longitudinal diffusion properties of normal-appearing white matter in 505 serial scans of 132 paediatric participants with acquired demyelinating syndromes followed for a median of 4.4 years, many from first clinical presentation, and 106 scans of 80 healthy paediatric participants...
March 14, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28332703/predictors-of-meaningful-improvement-in-quality-of-life-after-temporal-lobe-epilepsy-surgery-a-prospective-study
#4
Carla Pauli, Marcelo Liborio Schwarzbold, Alexandre Paim Diaz, Maria Emilia Rodrigues de Oliveira Thais, Charles Kondageski, Marcelo Neves Linhares, Ricardo Guarnieri, Bianca de Lemos Zingano, Juliana Ben, Jean Costa Nunes, Hans Joachim Markowitsch, Peter Wolf, Samuel Wiebe, Katia Lin, Roger Walz
OBJECTIVES: To investigate prospectively the independent predictors of a minimum clinically important change (MCIC) in quality of life (QOL) after anterior temporal lobectomy (ATL) for drug-resistant mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) in Brazilian patients. METHODS: Multiple binary logistic regression analysis was performed to identify the clinical, demographic, radiologic, and electrophysiologic variables independently associated with MCIC in the Quality of Life in Epilepsy-31 Inventory (QOLIE-31) overall score 1 year after ATL in 77 consecutive patients with unilateral MTLE-HS...
March 23, 2017: Epilepsia
https://www.readbyqxmd.com/read/28327056/multiple-sclerosis-and-suicide
#5
Anthony Feinstein, Bennis Pavisian
Mortality rates are elevated in people with multiple sclerosis (MS) relative to the general population. There is, however, some uncertainty whether suicide contributes to this. Epidemiological data suggest that the standardized mortality ratio (SMR) for suicide in MS is approximately twice that of the general population with younger males in the first few years following diagnosis most at risk. Rates of suicidal intent, a potential harbinger of more self-destructive behavior, are also elevated, but the frequency with which intent is followed by suicide is not known...
March 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28325251/interferon-induced-thrombotic-microangiopathy-tma-analysis-and-concise-review
#6
REVIEW
Ajay Kundra, Jen Chin Wang
Interferon (IFN) has been associated with development of thrombotic microangiopathy including thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). We reviewed literature from the earliest reported association in 1993, to July 2016 and found 68 cases. Analysis of this data shows: (1) Mean age at diagnosis was 47 years (95% CI, 44-50). (2) Majority of cases were seen where IFN was used for the treatment of chronic myelogenous leukemia (CML), multiple sclerosis (MS), chronic hepatitis C virus infection (HCV) and one case each for hairy cell leukemia (HCL) and Sezary syndrome...
April 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28323645/pediatric-multiple-sclerosis
#7
Anusha K Yeshokumar, Sona Narula, Brenda Banwell
PURPOSE OF REVIEW: This review discusses the epidemiologic factors involved in the pathogenesis of pediatric multiple sclerosis (MS), which have been the focus of numerous studies in the last several years. We also review the clinical features (including diagnostic evaluation and differential diagnosis) of, treatment approach to, and prognosis of pediatric MS. RECENT FINDINGS: Up to 10% of patients with MS have their initial demyelinating before the age of 18 years...
March 20, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28323224/progressive-multifocal-leukoencephalopathy-and-rheumatoid-arthritis-treatments
#8
Gaëlle Clavel, Antoine Moulignier, Luca Semerano
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system due to reactivation of the JC virus (JCV). PML is extremely uncommon despite the high prevalence of the virus in the general population. No specific treatment is available, and the prognosis is bleak. The diagnosis is based on brain imaging findings, detection of the JCV genome in cerebrospinal fluid samples and, in some cases, histological studies of the brain lesions. The pathophysiological mechanisms that drive the development of PML are incompletely understood...
March 16, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28320766/an-adverse-lipid-profile-and-increased-levels-of-adiposity-significantly-predict-clinical-course-after-a-first-demyelinating-event
#9
Prudence Tettey, Steve Simpson, Bruce Taylor, Anne-Louise Ponsonby, Robyn M Lucas, Terence Dwyer, Karam Kostner, Ingrid Af van der Mei
OBJECTIVE: To investigate the prospective associations between adiposity and lipid-related variables and conversion to multiple sclerosis (MS), time to subsequent relapse and progression in disability. METHODS: A cohort of 279 participants with a first clinical diagnosis of central nervous system demyelination was prospectively followed to 5-year review. Height, weight, waist and hip circumference were measured, and serum samples taken for measurement of lipids and apolipoproteins...
March 20, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28320130/spg2-mimicking-multiple-sclerosis-in-a-family-identified-using-next-generation-sequencing
#10
Anna Rubegni, Carla Battisti, Alessandra Tessa, Alfonso Cerase, Stefano Doccini, Alessandro Malandrini, Filippo M Santorelli, Antonio Federico
Several single gene disorders can potentially be overlooked in the differential diagnostic evaluation of patients with multiple sclerosis (MS). Pelizaeus-Merzbacher disease and spastic paraplegia type 2 are allelic X-linked disorders associated with defective myelination of the central nervous system and mutations in PLP1. Neurological symptoms are occasionally observed in female carriers of these mutations. Two women - the proposita (Pt1) and her mother (Pt2) - reported walking difficulties since adolescence and showed progressive cognitive decline...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28318337/the-association-of-timing-of-disease-modifying-drug-initiation-and-relapse-in-patients-with-multiple-sclerosis-using-electronic-health-records
#11
Frank A Corvino, David Oliveri, Amy L Phillips
OBJECTIVE: A large, US de-identified electronic health record (EHR) database (Optum-Humedica de-identified Electronic Health Record dataset) was used to evaluate whether earlier disease-modifying drug (DMD) treatment initiation was associated with improved outcomes in MS. METHODS: Newly diagnosed patients from 1/1/2008-8/30/2014 (International Classification of Diseases, Ninth Revision, Clinical Modification code: 340.xx; first MS diagnosis = index date) with healthcare activity 1 year pre- and 2-years post-index, and who initiated DMD treatment during the 2-year follow-up period, were included...
March 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28303911/comorbidity-in-multiple-sclerosis-implications-for-patient-care
#12
REVIEW
Ruth Ann Marrie
Most efforts aimed at understanding the notable heterogeneity of outcomes in multiple sclerosis (MS) have focused on disease-specific factors, such as symptoms at initial presentation, initial relapse rate, and age at symptom onset. These factors, however, explain relatively little of the heterogeneity of disease outcomes. Owing to the high prevalence of comorbidity in MS and the potential for its prevention or treatment, comorbidity is of rising interest as a factor that could explain the heterogeneity of outcomes...
March 17, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28302901/treatment-of-renal-angiomyolipoma-and-other-hamartomas-in-patients-with-tuberous-sclerosis-complex
#13
REVIEW
Joshua A Samuels
Tuberous sclerosis complex is an autosomal dominant genetic disease characterized by growth of benign tumors (hamartomas) in multiple organs, especially the kidneys, brain, heart, lungs, and skin. Tuberous sclerosis complex is usually caused by a mutation in either the tuberous sclerosis complex 1 or tuberous sclerosis complex 2 gene, resulting in constitutive activation of mammalian target of rapamycin signaling. Currently, mammalian target of rapamycin inhibitors are recommended in adult patients with tuberous sclerosis complex for the treatment of asymptomatic, growing renal angiomyolipoma that are >3 cm in diameter and pediatric or adult patients with brain lesions (subependymal giant cell astrocytoma) that either are growing or are not amenable to surgical resection...
March 16, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28301287/spinal-cord-lesions-a-modest-contributor-to-diagnosis-in-clinically-isolated-syndromes-but-a-relevant-prognostic-factor
#14
Georgina Arrambide, Alex Rovira, Jaume Sastre-Garriga, Carmen Tur, Joaquín Castilló, Jordi Río, Angela Vidal-Jordana, Ingrid Galán, Breogán Rodríguez-Acevedo, Luciana Midaglia, Carlos Nos, Patricia Mulero, Maria Jesús Arévalo, Manuel Comabella, Elena Huerga, Cristina Auger, Xavier Montalban, Mar Tintore
BACKGROUND: The usefulness of performing a spinal cord (SC) magnetic resonance imaging (MRI) in all clinically isolated syndromes (CIS) is controversial. OBJECTIVE: To assess the value of SC lesions for predicting multiple sclerosis (MS) diagnosis and disability accrual in CIS. METHODS: Concerning SC lesions and MS diagnosis (2010 McDonald), adjusted Cox regression analyses were performed in increasingly specific CIS groups: all cases ( n = 207), non-SC CIS ( n = 143), non-SC CIS with abnormal brain MRI ( n = 90) and non-SC CIS with abnormal brain MRI not fulfilling 2010 MS ( n = 67)...
March 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28285265/neuropsychiatric-syndromes-of-multiple-sclerosis
#15
REVIEW
Ruth Murphy, Stefani O'Donoghue, Timothy Counihan, Colm McDonald, Peter A Calabresi, Mohammed As Ahmed, Adam Kaplin, Brian Hallahan
Neuropsychiatric signs and symptoms occur frequently in individuals with multiple sclerosis (MS), either as the initial presenting complaint prior to a definitive neurological diagnosis or more commonly with disease progression. However, the pathogenesis of these comorbid conditions remains unclear and it remains difficult to accurately elucidate if neuropsychiatric symptoms or conditions are indicators of MS illness severity. Furthermore, both the disease process and the treatments of MS can adversely impact an individual's mental health...
March 11, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28283598/leptomeningeal-gadolinium-enhancement-across-the-spectrum-of-chronic-neuroinflammatory-diseases
#16
Martina Absinta, Irene C M Cortese, Luisa Vuolo, Govind Nair, Manori P de Alwis, Joan Ohayon, Alessandro Meani, Vittorio Martinelli, Roberta Scotti, Andrea Falini, Bryan R Smith, Avindra Nath, Steven Jacobson, Massimo Filippi, Daniel S Reich
OBJECTIVE: To assess the prevalence and the specificity of leptomeningeal enhancement (LME) on postcontrast T2-fluid-attenuated inversion recovery (FLAIR) MRI in multiple sclerosis (MS) compared to a variety of inflammatory and noninflammatory neurologic conditions assessed in 2 academic research hospitals. METHODS: On 3T postcontrast T2-FLAIR images, the presence of focal gadolinium enhancement was evaluated in the leptomeningeal compartment in 254 people with non-MS neurologic conditions or neurotropic viral infections...
March 10, 2017: Neurology
https://www.readbyqxmd.com/read/28283110/access-delivery-and-perceived-efficacy-of-physiotherapy-and-use-of-complementary-and-alternative-therapies-by-people-with-progressive-multiple-sclerosis-in-the-united-kingdom-an-online-survey
#17
Evan Campbell, Elaine Coulter, Paul Mattison, Angus McFadyen, Linda Miller, Lorna Paul
INTRODUCTION: All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine in people with progressive MS in the United Kingdom. METHODS: An online survey was carried out via the UK MS Register. Inclusion criteria were diagnosis of progressive MS, a member of UK MS Register and 18 years or older...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28283106/vogt-koyanagi-harada-syndrome-mimicking-multiple-sclerosis-a-case-report-and-review-of-the-literature
#18
REVIEW
Hussein Algahtani, Bader Shirah, Raghad Algahtani, Abdulah Alkahtani, Saeed Alwadie
Vogt Koyanagi Harada (VKH) Syndrome, also called uveomeningioencephalitis, is a chronic disorder characterized by inflammation of the uvea, meninges, auditory system, and integumentary system. The association between VKH syndrome and multiple sclerosis (MS) has been reported only once in the literature in a patient who developed VKH syndrome after two years of the diagnosis of MS. In this article, we report a case who was misdiagnosed and treated as MS until she was proven to have VKH syndrome, and a diagnosis of MS was excluded...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28283099/sensitivity-of-visual-evoked-potentials-and-spectral-domain-optical-coherence-tomography-in-early-relapsing-remitting-multiple-sclerosis
#19
COMPARATIVE STUDY
Raed Behbehani, Samar Ahmed, Jasem Al-Hashel, Rossen T Rousseff, Raed Alroughani
BACKGROUND: Visual evoked potentials and spectral-domain optical coherence tomography are common ancillary studies that assess the visual pathways from a functional and structural aspect, respectively. OBJECTIVE: To compare prevalence of abnormalities of Visual evoked potentials (VEP) and spectral-domain optical coherence tomography (SDOCT) in patients with relapsing remitting multiple sclerosis (RRMS). METHODS: A cross-sectional study of 100 eyes with disease duration of less than 5 years since the diagnosis...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28281110/headache-in-neuromyelitis-optica
#20
REVIEW
Alina Masters-Israilov, Matthew S Robbins
PURPOSE OF REVIEW: Neuromyelitis optica (NMO) classically features a clinical presentation that includes longitudinally extensive transverse myelitis and optic neuritis. However, many other pathognomonic phenomena have more recently been described in patients diagnosed with NMO, including intractable hiccups, vomiting, and painful tonic spasms, but less has been reported regarding the relationship between NMO and headache. Though headache is well established as both a symptom and comorbidity of multiple sclerosis (MS), it has been much less described thus far in the NMO literature and warrants more careful evaluation...
April 2017: Current Pain and Headache Reports
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