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Multiple Sclerosis
NIH - Medical Encyclopedia Multiple Sclerosis
"Multiple sclerosis (MS) usually affects woman more than men. The disorder most commonly begins between ages 20 and 40, but can strike at any age. The exact cause is not known, but MS is believed to result from damage to the myelin sheath, the protective material which surrounds nerve cells. It is a progressive disease, meaning the damage gets worse over time. Inflammation destroys the myelin, leaving multiple areas of scar tissue (sclerosis). The inflammation occurs when the body's own immune cells attack the nervous system. The inflammation causes nerve impulses to slow down or become blocked, leading to the symptoms of MS. Repeated episodes, or flare ups, of inflammation can occur along any area of the brain and spinal cord."
Highlighted ArticleThe role of MRI in the diagnosis of multiple sclerosis. (Adv Neurol. 2006)
"There is no single test that is diagnostic of MS, including MRI. The lesions detected with MRI are pathologically nonspecific. The principles of MS diagnosis are based on showing dissemination of white matter lesions in space and time. … The first important role for MRI in the diagnosis of MS allows for an early diagnosis of MS … The second important role for MRI in the diagnostic work-up of suspected MS patients is to rule out alternative diagnoses obvious on MRI, such as spinal stenosis and most brain tumors. Characteristic lesions that favor MS include Dawson Fingers, ovoid lesions, corpus callosum lesions, and asymptomatic spinal cord lesions. However, other white matter diseases can have similar appearances on MRI. … MRI evidence plays a supportive role in what is ultimately a clinical diagnosis of MS, in the appropriate clinical situation, and always at the exclusion of alternative diagnoses."
Multiple Sclerosis
General Information
NEWS:
Diabetes and MS linked in Danish study "People with type 1 diabetes are more than three times more likely to develop multiple sclerosis (MS) than are those without diabetes, new research from Denmark shows."
Infection may raise MS relapse risk: study "Results of a study of adults with relapsing remitting multiple sclerosis point to a significant association between viral and bacterial infections and increased risk of relapse … The team found a threefold increase in the rate of MS exacerbations during the "at-risk period" ranging from 2 weeks prior to 5 weeks after the onset of symptoms of infection, compared with time periods outside this window."
Outcome not always worse for late-onset MS " Individuals who develop multiple sclerosis (MS) later in life do not always have worse outcomes than those who develop the disease in early adulthood, according to a report in the journal Neurology. It has been assumed that patients who first develop MS symptoms after around 50 years of age have a poorer prognosis than those diagnosed earlier in life, Dr. Helen Tremlett told Reuters Health."
ARTICLES:
Demyelinating Optic Neuropathy (Optic Neuritis, Retrobulbar Optic Neuritis)
Multiple Sclerosis Symptoms-Visual Problems
JOURNAL ARTICLES:
A 50-year follow-up of the incidence of multiple sclerosis in Hordaland County, Norway. (Neurology. 2006)
Accumulation of irreversible disability in multiple sclerosis: From epidemiology to treatment (Clinical Neurology and Neurosurgery 2006)
Age at Onset of Multiple Sclerosis May Be Influenced by Place of Residence during Childhood Rather than Ancestry. (Neuroepidemiology. 2006)
Benign course in multiple sclerosis: a review (Acta Neurologica Scandinavica 2006)
Cancer risk among patients with multiple sclerosis: a population-based register study. (Int J Cancer. 2006) "In general MS patients are not at increased risk of cancer. Women with MS, however, seem to have a small excess risk of breast cancer, which cannot be attributed to reduced parity or delayed first child birth."
Childhood multiple sclerosis: A review. (Ment Retard Dev Disabil Res Rev. 2006)
Clinical and Demographic Predictors of Long-term Disability in Patients With Relapsing-Remitting Multiple Sclerosis (Arch Neurol. 2006) "Conclusions The most robust predictors of long-term physical disability in relapsing-remitting multiple sclerosis are sphincter symptoms at onset and early disease course outcomes. These factors can be used to guide treatment decisions for drugs with significant toxicities."
Clinical Course of Progressive Multiple Sclerosis in Brazilian Patients. (Neuroepidemiology. 2006)
Differential twin concordance for multiple sclerosis by latitude of birthplace. (Ann Neurol. 2006)
Disability progression in multiple sclerosis is slower than previously reported. (Neurology. 2006)
Epidemiology and natural history of multiple sclerosis: new insights. (Curr Opin Neurol. 2006) " . suggest that apolipoprotein E alleles play an important role. In the environmental realm, nested case-control studies show that prior Epstein-Barr virus exposure is overrepresented in multiple sclerosis. Smoking has been associated with both risk of multiple sclerosis and progressive disease. Vitamin D deficiency might tie together environmental clues with higher multiple sclerosis prevalence rates; dietary vitamin supplementation is also associated with reduced multiple sclerosis risk. ."
Epidemiology and treatment of pain in multiple sclerosis subjects. (eurol Sci. 2006)
Epstein-Barr Virus and Multiple Sclerosis (Arch Neurol. 2006) "Conclusion The elevation of anti-EBV titers is probably an early event in the pathogenesis of MS and is unlikely to be the result of an aspecific immune dysregulation."
Grey matter damage predicts the evolution of primary progressive multiple sclerosis at 5 years. (Brain. 2006)
High Prevalence and Fast Rising Incidence of Multiple Sclerosis in Caltanissetta, Sicily, Southern Italy. (Neuroepidemiology. 2006) "Conclusion: This survey shows the highest prevalence and incidence figures of MS in the Mediterranean area and confirms central Sicily as a very-high-risk area for MS."
High seroprevalence of Epstein–Barr virus in children with multiple sclerosis (NEUROLOGY 2006)
Increased prevalence of varicella zoster virus DNA in cerebrospinal fluid from patients with multiple sclerosis. (J Med Virol. 2006)
Increasing cord atrophy in early relapsing-remitting multiple sclerosis: a 3 year study. (J Neurol Neurosurg Psychiatry. 2006)
Iron and the folate-vitamin B12-methylation pathway in multiple sclerosis. (Metab Brain Dis. 2006)
Is late-onset multiple sclerosis associated with a worse outcome? (NEUROLOGY 2006)
Memory performance in multiple sclerosis patients correlates with central brain atrophy. (Mult Scler. 2006) "CONCLUSIONS: Memory performance shows a correlation with relative ventricular size in RRMS patients, indicating the strategic location of the ventricle system along the structures of the limbic system and its vulnerability in MS. The PASAT and several other cognitive tests show moderate correlations with depression and fatigue, arguing for an inter relation between the cognitive functioning and the emotional state of patients. However, this relation is independent of measurable brain atrophy."
Men transmit MS more often to their children vs women: the Carter effect. (Neurology. 2006)
[Mental disorders associated with multiple sclerosis] (Dtsch Med Wochenschr. 2006) "CONCLUSION: Mental disorders in patients with MS are manifold and their causes are complex. It is important to recognize these associated diseases and initiate individualized treatment, because they considerably impair the patients quality of life."
Mitochondrial dysfunction as a cause of axonal degeneration in multiple sclerosis patients. (Ann Neurol. 2006)
Multiple sclerosis mimics. (Adv Neurol. 2006)
Multiple sclerosis presenting with fantastic confabulation (General Hospital Psychiatry 2006) "Besides neurological signs and symptoms, the disease may be associated with various psychiatric manifestations, and uncommonly, psychiatric manifestations may be the presenting symptom. On the other hand, confabulation is defined as falsification of memory occurring in clear consciousness in association with an organically derived amnesia or as spontaneous narrative reports of events that never happened."
Multiple sclerosis with childhood onset: report of 21 cases in taiwan. (Pediatr Neurol. 2006) "In conclusion, childhood multiple sclerosis in Taiwan is frequently poly-symptomatic, and is characterized by a higher ratio of optic nerve and basal ganglion involvement. However, the optico-spinal form of multiple sclerosis occurs rarely in children in Taiwan. Our experience suggests that the chance of relapsing should not be overlooked in patients presenting with clinical and neuroimaging findings suggestive of acute disseminated encephalomyelitis."
[Multiple sclerosis : An update with practical guidelines for ophthalmologists.] (Ophthalmologe. 2006) "Multiple sclerosis (MS) is the most frequent chronic inflammatory disease of the central nervous system. Mostly young adults present with a variety of different symptoms due to the multiple localisations of the inflammatory lesions. Up to one-third of MS patients experience symptoms of optic neuritis as the initial symptom. That is the reason why the ophthalmologist often is the first physician contacted by patients later on diagnosed with MS."
Natural history of multiple sclerosis: a unifying concept. (Brain. 2006) "Multiple sclerosis can follow very different patterns of evolution and variable rates of disability accumulation. This raises the issue whether it represents one or several distinct diseases. . From the clinical and statistical positions, multiple sclerosis might be considered as one disease with different clinical phenotypes rather than an entity encompassing several distinct diseases-the position of complexity rather than true heterogeneity."
Pain as heralding symptom in multiple sclerosis. (eurol Sci. 2006) "Pain may be one of the heralding symptoms of MS. In the present series it was severe, chronic and poorly responsive to treatment. A sensory examination is mandatory in all cases of complex pain syndromes of unidentified nature."
Pediatric multiple sclerosis. (NeuroRx. 2006) "SUMMARY: Multiple sclerosis (MS) occurs at all ages of the pediatric population. Childhood MS may represent up to 10% of all MS cases. Establishing the diagnosis of MS in a child is complicated by the limited diagnostic criteria and the possibility of significant clinical and magnetic resonance imaging (MRI) overlap with acute disseminated encephalomyelitis and other pediatric diseases. Although the clinical profile of MS appears similar to that seen in adults, several features may differ and specific issues arise in children."
Persistent pain and uncomfortable sensations in persons with multiple sclerosis. (Pain. 2006)
Remyelination is extensive in a subset of multiple sclerosis patients (Brain 2006)
Secondary progressive multiple sclerosis: current knowledge and future challenges. (Lancet Neurol. 2006) "The secondary progressive phase of multiple sclerosis (MS), which is characterised by a steady accrual of fixed disability after an initial relapsing remitting course, is not clearly understood. Although there is no consensus on the mechanisms underlying such a transition to the progressive phase, epidemiological and neuroimaging studies indicate that it is probably driven by the high prevalence of neurodegenerative compared with inflammatory pathological changes. . "
Seroprevalence of herpes simplex virus type 2 in multiple sclerosis (Acta Neurologica Scandinavica 2006) "It is concluded that there is increased likelihood of HSV-2 exposure in patients with MS and this may indicate a higher than average number of partners."
Sleep and fatigue in multiple sclerosis. (Mult Scler. 2006) "Sleep disturbance is common in MS and is associated with treatable symptoms, including pain and nocturia. Sleep disturbance may be an important factor contributing to fatigue in patients with MS."
Tetanus vaccination and risk of multiple sclerosis: a systematic review. (Neurology. 2006) "CONCLUSION: Tetanus vaccination is associated with a lower risk of multiple sclerosis."
The clinical features, MRI findings, and outcome of optic neuritis in children. (Neurology. 2006) "CONCLUSIONS: Contrary to expectations, optic neuritis (ON) in childhood was more likely to be unilateral, multiple sclerosis (MS) risk was high (36% at 2 years), and bilateral rather than unilateral ON was associated with a greater likelihood of MS. Clinical findings extrinsic to the visual system on baseline examination (p < 0.0001) and MRI evidence of white matter lesions outside the optic nerves (p < 0.0001) were strongly correlated with MS outcome."
The natural history of multiple sclerosis: a geographically based study 9: observations on the progressive phase of the disease. (Brain. 2006) "The clinical features of relapses and progression largely define multiple sclerosis phenotypes. A relapsing course is followed by chronic progression in some 80% of cases within 2 decades. The relationship between these phases and long-term outcome remains uncertain. . Despite considerable individual variation, the progressive course of disability seen in groups of PP, SAP and SP-DSS2 is similarly stereotyped in quality and pace and may entail mechanisms common to all forms of progressive multiple sclerosis. The possibility that this is the primary process in some cases must be considered."
The pathology of multiple sclerosis: a paradigm shift. (Curr Opin Neurol. 2006)
The Role of Vitamin D in Multiple Sclerosis . (Ann Pharmacother. 2006)
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