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Oligoclonal bands

S Kemp, R S Allan, N Patanjali, M H Barnett, B P Jonker
We report a unique case of neurological deficit from late onset multiple sclerosis (MS), in a 65-year-old woman, after stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN). At 3.5months post-SRS for TN, the patient developed ataxia and left leg paraesthesiae and brain MRI showed altered signal and enhancement in the vicinity of the right trigeminal root entry zone (REZ). The symptoms remitted following treatment with intravenous methylprednisolone, however, 10months post-SRS, the patient developed gait ataxia and left lower limb weakness...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
André Huss, Mathias Buttmann, Isabel Brecht, Andreas Weishaupt, Markus Otto, Hayrettin Tumani
OBJECTIVES: Beside the determination of oligoclonal bands (OCBs) as a diagnostic biomarker in multiple sclerosis (MS), the presence of an intrathecal production of antibodies against the neurotropic viruses measles (M), rubella (R) and Varicella-Zoster (Z), the so called MRZ reaction (MRZR) is an even more specific diagnostic biomarker in MS. METHODS: We compared and validated the determination of the MRZR in 97 cerebrospinal fluid (CSF) and serum sample pairs of a bead-based multiplexing technique and a classical enzyme-linked immunosorbent assay (ELISA)...
October 19, 2016: Expert Review of Molecular Diagnostics
Nabil K El Ayoubi, Samia J Khoury
Multiple sclerosis (MS) is an autoimmune demyelinating disorder of the central nervous system. Only a few biomarkers are available in MS clinical practice, such as cerebrospinal fluid oligoclonal bands and immunoglobulin index, serum anti-aquaporin 4 antibodies, and serum anti-John Cunningham virus antibodies. Thus, there is a significant unmet need for biomarkers to assess prognosis, response to therapy, or potential treatment complications. Here we describe emerging biomarkers that are in development, focusing on those from peripheral blood...
October 18, 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Edgar Carnero Contentti, Mariana De Virgiliis, Javier Pablo Hryb, Felisa Leguizamon, Julia Celso, José Luis Di Pace, Mónica Perassolo
BACKGROUND: Antibodies against aquaporin-4 (AQP4-ab) have diagnostic and prognostic value. However, little is known to date about their utility in the first event of optic neuritis (ON). OBJECTIVE: To evaluate the utility of systematic AQP4-ab determination in a retrospective cohort of patients with a first onset of ON. PATIENTS AND METHODS: All patients (n = 42) were tested for AQP4-ab in the following context: typical ON (TON) and atypical ON (AON)...
October 13, 2016: European Neurology
André M Huss, Steffen Halbgebauer, Patrick Öckl, Corinna Trebst, Annette Spreer, Nadja Borisow, Andrea Harrer, Isabel Brecht, Bettina Balint, Oliver Stich, Sabine Schlegel, Nele Retzlaff, Alexander Winkelmann, Romy Roesler, Florian Lauda, Özlem Yildiz, Elke Voß, Rainer Muche, Sebastian Rauer, Florian Then Bergh, Markus Otto, Friedemann Paul, Brigitte Wildemann, Jörg Kraus, Klemens Ruprecht, Martin Stangel, Mathias Buttmann, Uwe K Zettl, Hayrettin Tumani
The majority of patients presenting with a first clinical symptom suggestive of multiple sclerosis (MS) do not fulfill the MRI criteria for dissemination in space and time according to the 2010 revision of the McDonald diagnostic criteria for MS and are thus classified as clinically isolated syndrome (CIS). To re-evaluate the utility of cerebrospinal fluid (CSF) analysis in the context of the revised McDonald criteria from 2010, we conducted a retrospective multicenter study aimed at determining the prevalence and predictive value of oligoclonal IgG bands (OCBs) in patients with CIS...
October 11, 2016: Journal of Neurology
Tanawat Tengsirikomol, Sasitorn Siritho, Naraporn Prayoonwiwat
BACKGROUND AND PURPOSE: A few reports studied the time use to diagnose patient with neuromyelitis optica (NMO). The Aim of the study is to evaluate the interval from disease onset to the time when patients fulfilled the NMO diagnostic criteria 2006 in Thai. METHOD: A retrospective study of the NMO patients visiting the MS clinic and related disorders at Siriraj hospital was reviewed. RESULTS: There were 42 definite NMO. All were female. The most common first presentations were optic neuritis (ON) (45...
September 2016: Multiple Sclerosis and related Disorders
Anand Venkatraman, Puneet Opal
The ataxic syndrome associated with Anti-Yo antibody, or Purkinje cell cytoplasmic antibody type 1 (PCA1), is the most common variant of paraneoplastic cerebellar degeneration (PCD). The typical presentation involves the subacute development of pancerebellar deficits with a clinical plateau within 6 months. The vast majority of cases have been reported in women with pelvic or breast tumors. Magnetic resonance imaging of the brain is often normal in the early stages, with cerebellar atrophy seen later. The underlying mechanism is believed to be an immunological reaction to cerebellar degeneration-related protein 2 (CDR2), a protein usually found in the cerebellum that is ectopically produced by tumor cells...
August 2016: Annals of Clinical and Translational Neurology
Renata Conforti, Raffaella Capasso, Rosario Galasso, Mario Cirillo, Gemma Taglialatela, Luigi Galasso
BACKGROUND: Tumefactive multiple sclerosis (MS) is an unusual variant of demyelinating disease characterized by lesions with pseudotumoral appearance on radiological imaging mimicking other space-occupying lesions, such as neoplasms, infections, and infarction. Especially when the patient's medical history is incompatible with MS, the differential diagnosis between these lesions constitutes a diagnostic challenge often requiring histological investigation. An older age at onset makes distinguishing tumefactive demyelinating lesion (TDL) from tumors even more challenging...
September 2016: Medicine (Baltimore)
Seema Bangalore Hanumanthe, Carla Francisco, Janace Hart, Jennifer Graves, Emmanuelle Waubant
Pediatric tumefactive lesions remains challenging to clinicians in terms of diagnosis and treatment. The authors describe 11 children with biopsy-proven central nervous system tumefactive demyelination. The mean age of onset was 11 years. Clinical and radiological data coupled with biopsy aided in the diagnosis of tumefactive demyelination. Of the 6 cases in which oligoclonal band data were available, only 3 showed oligoclonal band in the cerebrospinal fluid. Due to poor recovery despite treatment with high-dose glucocorticosteroids, intravenous immunoglobulin, and/or plasmapheresis, 6 cases went on to receive cyclophosphamide with marked improvement...
August 29, 2016: Journal of Child Neurology
Hai Chen, Shi-Meng Liu, Xu-Xiang Zhang, Ya-Ou Liu, Si-Zhao Li, Zheng Liu, Hui-Qing Dong
BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) was long believed to be an aggressive form of multiple sclerosis (MS). This study aimed to describe the clinical features of patients with MS and NMOSD to assist in differential diagnoses in clinical practice. METHODS: Data including the patients' serum and cerebrospinal fluid (CSF) tests, image findings, and clinical information from 175 patients with MS or NMOSD at Xuanwu Hospital, Capital Medical University from November 2012 to May 2014 were collected and analyzed retrospectively...
2016: Chinese Medical Journal
Mar Tintore, Susana Otero-Romero, Jordi Río, Georgina Arrambide, Berta Pujal, Carmen Tur, Ingrid Galán, Manuel Comabella, Carlos Nos, María Jesús Arévalo, Angela Vidal-Jordana, Joaquin Castilló, Breogán Rodríguez-Acevedo, Luciana Midaglia, Raquel Mitjana, Cristina Auger, Jaume Sastre-Garriga, Àlex Rovira, Xavier Montalban
OBJECTIVE: To study the contribution of the symptomatic lesion in establishing multiple sclerosis (MS) diagnosis and prognosis. METHODS: We performed an observational study based on a prospective clinically isolated syndrome (CIS) cohort of 1,107 patients recruited for clinical and brain MRI follow-up from 1995 to 2014. Eligible patients (n = 954) were divided into 4 groups according to baseline MRI: patients with a normal MRI (n = 290); patients with a single asymptomatic lesion (n = 18); patients with a single cord/brainstem symptomatic lesion (n = 35); and patients with more than 1 lesion (n = 611)...
September 27, 2016: Neurology
Georgina Arrambide, Carmen Espejo, Herena Eixarch, Luisa M Villar, José C Alvarez-Cermeño, Carmen Picón, Jens Kuhle, Giulio Disanto, Ludwig Kappos, Jaume Sastre-Garriga, Deborah Pareto, Eva Simon, Manuel Comabella, Jordi Río, Carlos Nos, Carmen Tur, Joaquín Castilló, Angela Vidal-Jordana, Ingrid Galán, Maria J Arévalo, Cristina Auger, Alex Rovira, Xavier Montalban, Mar Tintore
OBJECTIVE: To determine the prognostic value of selected biomarkers in clinically isolated syndromes (CIS) for conversion to multiple sclerosis (MS) and disability accrual. METHODS: Data were acquired from 2 CIS cohorts. The screening phase evaluated patients developing clinically definite MS (CIS-CDMS) and patients who remained as CIS during a 2-year minimum follow-up (CIS-CIS). We determined levels of neurofascin, semaphorin 3A, fetuin A, glial fibrillary acidic protein, and neurofilament light (NfL) and heavy chains in CSF (estimated mean [95% confidence interval; CI])...
September 13, 2016: Neurology
Renata Balnytė, Daiva Rastenytė, Antanas Vaitkus, Erika Skrodenienė, Astra Vitkauskienė, Ingrida Ulozienė
BACKGROUND AND AIM: Oligoclonal bands (OCB) may be associated with the genes of HLA complex, which allows to consider the possible interaction of genetic and immunological factors and its importance in the development and progression of multiple sclerosis (MS). The aim of this study was to evaluate the associations between HLA DRB1 alleles and oligoclonal bands (OCBs) in the disease course and disability of multiple sclerosis (MS) patients. MATERIALS AND METHODS: This was a prospective study of 120 patients with MS...
2016: Medicina
Ricardo Erazo, Jaime González, Consuelo Quintanilla, Claudia Devaud, Consuelo Gayoso, Ximena Toledo, Erna Rauch, Claudia Riffo, Carolina Alvarez, Marne Salazar, Daniela Salvo, Josep Dalmau, Orietta Carmona
INTRODUCTION: Subacute anti-NMDA receptor encephalitis was recognised in 2007 as a clinical entity, and was first described in young women with ovarian teratoma. The first paediatric series unrelated with tumours was reported in 2009. OBJECTIVE: To present the clinical features, treatment, and prognosis of 13 patients with anti-NMDA receptor encephalitis in Chile. PATIENTS AND METHOD: A description is presented of 13 children, 9 males, aged between 1 and 16 years, diagnosed between 2009 and 2016 in 7 hospitals...
July 28, 2016: Revista Chilena de Pediatría
João Dias Ferreira, Ana Castro Caldas, João Correia de Sá, Ruth Geraldes
Nervous system involvement in Hepatitis C virus infection (HCV) has been associated to neuro-immunological deregulation, particularly in interferon-alpha treated patients. We present a case of optic and brainstem demyelinating disorder associated with aquaporin-4 (AQP4) antibodies. A 48 year-old woman, with previous diagnosis of non-treated hepatitis C, presented with a 10-year history of long-standing gait disturbance. Neurological examination disclosed a grade 4 spastic paraparesis, lower limb hyperreflexia, right positive Hoffmann sign, bilateral Babinski sign and spastic gait only possible with bilateral support...
July 2016: Multiple Sclerosis and related Disorders
Richard A Prayson
Sarcoidosis is a well-recognized systemic granulomatous process which involves the central nervous system in 5-15% of patients. One of the more frequent sites of central nervous system involvement is the pituitary and hypothalamic region. Involvement of the sellar region by sarcoidosis is overall an infrequent occurrence, comprising less than 1% of all intrasellar lesions. Patients typically present with an infiltrative lesion on imaging studies and clinically with symptoms related to diabetes insipidus or hyperprolactinemia...
July 21, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hong Qi Yang, Wen Cong Zhao, Wei Min Yang, Yong Li Li, Zhi Kun Sun, Shuai Chen, Wei Li, Jian Jun Ma
BACKGROUND AND PURPOSE: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that predominantly affects children. Previous studies have mostly involved children in Western developed countries. METHODS: This study retrospectively reviewed the clinical profiles of ADEM in adult Chinese patients. RESULTS: ADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in five patients and no preimmunization was recorded...
July 2016: Journal of Clinical Neurology
D Lopez-Martin, J Martinez-Anton
INTRODUCTION: In children, the most common form of optic neuritis usually occurs after an infectious disease with papilledema, usually bilateral and has a good prognosis. Conversion to multiple sclerosis is low. AIM: To present clinical and laboratory case of optic neuritis in pediatrics features. PATIENTS AND METHODS: Seventeen clinical cases of optic neuritis in children and young people aged 4-14 years, referred from 2000 to 2015 were analyzed...
August 1, 2016: Revista de Neurologia
M Puthenparampil, S Miante, L Federle, C Zanetta, E Toffanin, S Ruggero, F Rinaldi, P Gallo
B-cells are thought to play a relevant role in multiple sclerosis (MS) pathology. BAFF (B cell activating factor of the TNF family) is a B-cell survival factor constitutively produced inside the CNS by astrocytes. We studied the intrathecal synthesis of BAFF in MS at clinical onset. Paired serum and cerebrospinal fluid (CSF) specimens from 40 clinically isolated syndromes (CIS) suggestive of MS or early relapse-onset MS (eRRMS) and from 18 healthy controls (HC) were analysed. Patients were classified based on the detection of oligoclonal IgG bands in the CSF (IgGOB+ and IgGOB-)...
August 15, 2016: Journal of Neuroimmunology
Kaushiki Biswas, Dhriti Chatterjee, Sankar Addya, Reas S Khan, Lawrence C Kenyon, Alexander Choe, Randall J Cohrs, Kenneth S Shindler, Jayasri Das Sarma
The presence of immunoglobulin oligoclonal bands in the cerebrospinal fluid of Multiple Sclerosis (MS) patients supports the hypothesis of an infectious etiology, although the antigenic targets remain elusive. Neurotropic mouse hepatitis virus (MHV) infection in mice provides a useful tool for studying mechanisms of demyelination in a virus-induced experimental model of MS. This study uses Affymetrix microarray analysis to compare differential spinal cord mRNA levels between mice infected with demyelinating and non-demyelinating strains of MHV to identify host immune genes expressed in this demyelinating disease model...
September 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
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