Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MULTIPLE SCLEROSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,099 records · Page 61Linked to original sources
PubMed1992

Multiple sclerosis: common management issues.

Multiple sclerosis, the commonest neurological disease of young Australians, has a wide range of symptoms and may lead to varying degrees of physical and cognitive disability. Characteristically, the disease runs an episodic course, but it may be progressive from the outset. To date, treatments aimed at modifying the disease process have been disappointing, but recognition and management of the symptoms have improved, leading to an improved quality of life for people with multiple sclerosis.

Brain↗
PubMed1992

Quantitative MR in the diagnosis of multiple sclerosis.

In patients with multiple sclerosis (MS), the apparently uninvolved cerebral white matter between demyelinated plaques may have biochemical abnormalities. To what degree the changes in the white matter contribute to symptomatology in MS is unknown. In 39 patients with multiple sclerosis, and in 39 age-matched nondiseased volunteers, T1 and T2 were calculated from spin-echo images in four regions of apparently uninvolved white matter. In three of four white matter areas, the average T1 and T2 were significantly longer in the patients than in the controls. The T1 correlated with the disability, measured by the Kurtzke Extended Disability Status Scale, although the correlation was marginally significant. The results suggest that in patients with MS, white matter disease that is not visualized in MR as distinct foci of abnormal signal intensity may contribute to disease burden and disability.

Brain↗
PubMed2002

Treatment of multiple sclerosis with the pregnancy hormone estriol.

Multiple sclerosis patients who become pregnant experience a significant decrease in relapses that may be mediated by a shift in immune responses from T helper 1 to T helper 2. Animal models of multiple sclerosis have shown that the pregnancy hormone, estriol, can ameliorate disease and can cause an immune shift. We treated nonpregnant female multiple sclerosis patients with the pregnancy hormone estriol in an attempt to recapitulate the beneficial effect of pregnancy. As compared with pretreatment baseline, relapsing remitting patients treated with oral estriol (8 mg/day) demonstrated significant decreases in delayed type hypersensitivity responses to tetanus, interferon-gamma levels in peripheral blood mononuclear cells, and gadolinium enhancing lesion numbers and volumes on monthly cerebral magnetic resonance images. When estriol treatment was stopped, enhancing lesions increased to pretreatment levels. When estriol treatment was reinstituted, enhancing lesions again were significantly decreased. Based on these results, a larger, placebo-controlled trial of estriol is warranted in women with relapsing remitting multiple sclerosis. This novel treatment strategy of using pregnancy doses of estriol in multiple sclerosis has relevance to other autoimmune diseases that also improve during pregnancy.

Adolescent↗
PubMed1986

Contrast sensitivity during provoked visual impairment in multiple sclerosis.

Many patients with multiple sclerosis have subjective visual complaints that are intensified by exercise (Uhthoff's symptom). We report a case demonstrating the utility of contrast sensitivity testing in such visual complaints. Contrast sensitivity was measured before and after exercise in a multiple sclerosis patient with Uhthoff's symptom and in two healthy control subjects. A short exercise period reduced the patient's contrast sensitivity for some target sizes, but had no effect on his visual acuity; a longer exercise period produced a greater, more uniform loss of contrast sensitivity and also reduced visual acuity. Contrast sensitivities and visual acuities of the control subjects were not affected by exercise.

Adult↗
PubMed2000

Lead poisoning from complementary and alternative medicine in multiple sclerosis.

A patient with multiple sclerosis is described who was treated for neurological symptoms thought to be a progression of his disease but subsequently found to be caused by lead poisoning secondary to the use of alternative medicine. His clinical signs improved with oral chelation therapy. Neurologists should consider asking about the use of complementary and alternative medicine before simply attributing symptoms and signs to exacerbation of multiple sclerosis.

Brain↗
PubMed1987

Paradoxical effects of temperature in multiple sclerosis.

Six cases of multiple sclerosis are reported in which cold produced a temporary exacerbation of symptoms and signs of the disease. Also, in one case investigated in detail by psychophysical methods, heating produced a paradoxical deterioration in vision and simultaneous improvement in sensory and motor function. The effect of temperature in multiple sclerosis is discussed and a physiological explanation for the paradoxical response to heating is suggested.

Adult↗
PubMed2001

[Hospital-at-home as a solution for the treatment requirements of acute exacerbation in multiple sclerosis].

Cooperation between the Multiple Sclerosis center at the Carmel medical center and the Hospital-at-Home (H.H) department of the continuing care unit in the Haifa and Western Galilee district of the Clalit Health Services has made it possible to give methylprednisolone intravenously to Multiple Sclerosis (M.S) patients during an acute exacerbation of the disease, in their home. In this study, we describe the joint work of the two centers. We have summarized 30 treatment courses given to 26 patients in their homes, following referral by the M.S. center, in the year 1999. The aims of the study included assessing satisfaction, safety and cost-effectiveness in a treatment course in the HH framework, as compared to the same treatment being conducted in the framework of hospitalization in various neurological departments, as was done in the past in the same group of patients. The expenses involved in HH for this group of patients were only 14% of the parallel treatment in the hospital (a savings of 86%). The treatment has proven to be extremely safe. There were no side-effects that required returning patients to the hospital, and the treatment was given in conditions of maximum comfort for the patient and his family. A telephone survey was conducted, which compared the satisfaction with the HH treatment, and the burden caused the patient's family to prior hospitalization for the same treatment. For all of the parameters examined, greater satisfaction was distinctly proven in the HH treatment. In light of these findings, we can conclude that giving methylprednisolone intravenously to M.S patients during an acute exacerbation, in the HH framework, is a safe and cost effective treatment, preferred by the patient and his family.

Caregivers↗
PubMed2002

Anti-inflammatory strategies to prevent axonal injury in multiple sclerosis.

Axonal injury in multiple sclerosis has attracted considerable interest during the past few years. It has been demonstrated in association with inflammation within active lesions, but it is also present in normal-appearing white matter. Because axonal loss appears to be responsible for persistent neurological deficits in patients with multiple sclerosis, treatment strategies to prevent damage to neurites and restore function are of paramount importance in controlling the disease process. Some of the currently available immunomodulatory therapies may also reduce axonal damage, as demonstrated using improved imaging technologies, but the precise mechanisms that could protect axons during the inflammatory attack are yet to be identified. Factors that are involved in functional impairment of axonal conduction and those elements that are responsible for direct structural damage to the axon are both potential targets for therapeutic interventions.

Animals↗
PubMedDate not supplied

Chronic sorrow in multiple sclerosis. A case study.

Multiple sclerosis, one of the most common chronic disabilities among young adults, may potentiate the occurrence of chronic sorrow. Chronic sorrow differs from acute grief because it is permanent, periodic, and progressive in nature; it may be a normal component of chronic illness and disability. This study describes one woman's experience with multiple sclerosis, her chronic sorrow about the trajectory of her disability, her progressive loss of bodily function, and the stigma of chronic illness. It also reports some of the feelings experienced by her husband, the primary caregiver.

Caregivers↗
PubMed2005

Treatment of neuropsychiatric syndromes in multiple sclerosis.

The treatment of multiple sclerosis has been revolutionized during the past 10 years by the introduction of disease-modifying therapies. However, day-to-day management of the symptoms and complications of this condition will, for the foreseeable future, continue to be important management concerns. Among the most problematic and troublesome manifestations of multiple sclerosis are its neuropsychiatric manifestations. Most prominent among these are depression, pathologic laughing and crying, fatigue, cognitive problems, sleep disorders and disorders of sexual function. There have been relatively few randomized controlled trials of pharmacologic treatments for these conditions. Available treatments for the management of fatigue and cognitive deficits remain inadequate and patients must often accommodate these symptoms in their lifestyle.

Major Depressive Disorder↗
PubMedDate not supplied

MR lesion load and cognitive function in patients with relapsing-remitting multiple sclerosis.

BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is a demyelinating disease most often associated with progressive physical impairment; however, its effects are noted to extend beyond physical disability. Our purpose was to determine the relationship between T2 lesion volume and neurocognitive and physical disability in relapsing-remitting multiple sclerosis. METHODS: We studied a cohort of 19 patients with relapsing-remitting MS. Of this group, there were 15 women and four men from varying socioeconomic backgrounds. This volunteer sample was selected from a larger group of 53 patients with MS in our longitudinal MS study because they had been untreated with any beta-interferon medications, had been followed for at least 12 months, and had a clinical status of relapsing-remitting MS. RESULTS: Of 12 neurocognitive parameters tested, two correlated significantly with lesion loads. The correlation of the Symbol-Digit Modalities test, which analyzes information-processing speed, was significant (P = .0204). The correlation of the fifth trial of the Rey Auditory Verbal Learning test, which tests verbal long-term memory, was also significant (P = .0348). None of the other 10 neurocognitive examinations, however, showed a significant correlation with total lesion volume (Paced Auditory Serial Addition test-1.6, P = .7381; Paced Auditory Serial Addition test-2.0, P = .4180; Controlled Oral Word Association test, P = .8906; Category Fluency test, P = .4423; Bells test, P = .9097; Rey Auditory Verbal Learning test-delay, P = .9843, Rey Auditory Verbal Learning test-recognition, P = .7467; Word Span test, P = .4939; Road Map test, P = 0.4939). The lesion load also did not correlate with the physical disability scales as rated according to the Expanded Disability Status Scale (P = .68) or Ambulation Index (P = .95). CONCLUSION: Our results indicate that T2 lesion volume does not seem to be a robust surrogate marker of neuropsychological impairment in patients with MS. We think that global measurements of parameters that are more specific to the disease process may offer more precise correlation with cognitive dysfunction and other disability parameters.

Adult↗
PubMed1999

[Social and economic impact of multiple sclerosis].

The evolution of multiple sclerosis is unforeseeable; it can induce disability and fatigue; thus, it has a socio-economical impact. Married and family life, relationships and work are the most affected areas. Financial problems can also occur. Counselling and aid services must be provided. All these social impacts induce an indirect cost which is the major component of the total cost of multiple sclerosis. Data show that there are great differences between countries and that the cost increases when there is a disability. The economic impact of the "new" drugs is unknown and must be assessed.

Counseling↗
PubMed1984

Multiple sclerosis.

The cause of multiple sclerosis is unknown but seems to be multifactorial. Susceptibility or resistance may be genetically determined; something in the environment interacts with the human host at the proper age to cause biochemical and structural lesions in the central nervous system. The systemic immune response and the response of the central nervous system become involved. Although multiple sclerosis cannot yet be cured, many clues are leading to an effective palliative therapy. Suppression or modulation of the immune responses may be the key to developing that treatment. If the environmental agent is one or several viruses, then antiviral regimens will be appropriate. Research must therefore continue at both basic science and clinical levels.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

[Immunological markers of disease activity in the course of 2-CDA treatment of multiple sclerosis].

52 clinically definite multiple sclerosis (MS) patients were treated with subcutaneous injection of 5 mg 2-CDA in 5 consecutive days. The injection courses were repeated 6 times in one month interval. The MRI pattern and immunological markers were studied in serum and CSF before and after 6 months of treatment. The obtained results suggest that treatment with 2-CDA has not any significant effect on humoral immunological events in multiple sclerosis, what is in contrast to some normalization of cellular immunopathological processes.

2-Chloroadenosine↗
PubMed2002

Alphabet soup: a personal, evolving, mostly evidence-based and logical, sequential approach to the "ABCNR" drugs in multiple sclerosis.

With the development of multiple options for immunotherapy in multiple sclerosis, the clinician is faced with the challenge of keeping pace with the literature, acquiring familiarity with the various treatment options and opinions, and then offering the patients the most current and appropriate management. Given the inherent nature of a multifocal and unpredictable disease such as multiple sclerosis, along with the availability of multiple treatment options, it behooves the clinician to develop an evidence-based rationale for how to best manage patients. This article reflects the common questions that arise from referring neurologists regarding my personal approach to the management of patients with multiple sclerosis.

Adrenal Cortex Hormones↗
PubMed2002

[Effect of variable magnetic field on motor impairment and quality of life in patients with multiple sclerosis].

Modern treatment of multiple sclerosis (SM) takes into consideration the current stage of the disease, symptomatic treatment and modification of the course of the disease. The most promising method of management is immunotherapy. It is, however, effective only in some cases, in patients with low degree of disability, and it is rather expensive. In view of some recent reports concerning the possibility of utilisation of variable magnetic fields in the treatment of SM, the study was undertaken to evaluate the effectiveness of impulses generated by magnetic field obtained by means of VIOFOR JPS stimulator. The study was carried out on 76 subjects with long-term history of clinically confirmed SM. The mean duration of the disease was 8.5 years, and the mean age of the patients 37.8 years. The patients were divided into two groups: the study group and the controls. In the study group the patients were exposed to magnetic fields generated by VIOFOR JPS. Magnetic stimulation was not applied in the control group. The progress of the disease according to EDDS and the quality of life according to Testa and Simonson Questionnaire were assessed on admission and after 21 days of stimulation. No significant differences between the groups were found with respect to motor impairment evaluated using the EDDS score (6.2 at the beginning of the study and 5.1 after 21 days; in the control group--6.1 and 5.6, respectively). The quality of life was found to be significantly better in the group exposed to magnetic field stimulation than in the controls (p < 0.01). Particular variables contributing to the physical, psychological and social component of quality of life were analysed in detail. The most significant difference was observed with respect to the improvement of mental condition of the patients (alleviation of depression, elimination of anxiety, better emotional control), as well as to the decrease of muscle tone, dysaesthesia and painful sensations. No side effects were observed in any of the cases. The obtained effects encourage us to recommend magnetic stimulation as a method supplementing symptomatic treatment of patients with multiple sclerosis.

Activities of Daily Living↗
PubMed2000

[Giant lesions in multiple sclerosis--a diagnostic challenge].

Multiple sclerosis is the most common demyelinating disease of the central nervous system affecting young adults, in which destruction of the axon myelin sheath disturbs signal transduction. The disease course is usually remitting and relapsing, but sometimes there is steady neurological deterioration. The diagnosis depends mainly on an adequate clinical history and neurological examination. Evoked potentials, elevated cerebrospinal fluid gamma globulin with oligoclonal bands, and imaging studies, mainly magnetic resonance imaging (MRI), also contribute to the diagnosis. Multiple sclerosis may occasionally present as a mass lesion that clinically and radiologically is indistinguishable from a brain tumor. We present 2 cases of giant tumefactive lesions, proven by brain biopsy to be of demyelinating nature.

Adult↗
PubMed2003

[Multiple sclerosis and magnetic resonance].

Multiple sclerosis is a demyelinating process presently referred to autoimmune diseases. Its diagnostics is based on clinical examination and paraclinical tests (magnetic resonance, examination of CSF and evoked potentials recording). Magnetic resonance (MR) has the highest significance, both for the diagnostics and for the monitoring of the course of disease and results of treatment. Results of magnetic resonance are not specific for the multiple sclerosis and therefore for the reliable diagnosis the McDonadl's criteria have to be fulfilled. It appears that magnetic resonance is more sensitive to progression of disease than the clinical examination. Monitoring of the course of disease requires new techniques of MR imaging. Automatic, software assisted determination of plaque volumes in T2 and T1 weighted images--so called "lesion load", is checked during the patient's treatment. Assessment of brain volume determines progression of atrophy. The aim of all the new methods of MR imaging is to search for a reliable technique of the disease monitoring and namely for the prediction of disease progression.

Brain↗