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At least 1,153 records · Page 64Linked to original sources

Optic neuritis as onset manifestation of multiple sclerosis: a nationwide, long-term survey.

OBJECTIVE: To determine the predictive value on survival of optic neuritis (ON) as onset manifestation of MS. METHODS: We used data obtained from the Danish Multiple Sclerosis Registry, which includes virtually all patients diagnosed with MS in Denmark. From 1949 to 1990, 7,548 unselected patients fulfilling standardized diagnostic criteria of MS were registered. RESULTS: The onset manifestation of MS was known in 6,923 patients, and was ON in 1,282 patients (19%). The mean age at onset was 31.1 years for these patients compared with 34.8 years for patients with another or unknown onset manifestation of MS (non-ON) (p < 0.001). The mean delay from the first known manifestation of MS to the final diagnosis of MS was 6.1 years (ON) and 4.2 years (non-ON). The median survival time from onset of ON was 30 years in men (compared with 41 years in the matched general male population) and 40 years in women (versus 47 years). The excess death rate increased with age at onset of MS in people of each sex. Excess death rate for women differed significantly between patients with ON as onset manifestation and patients with another or unknown onset manifestation of MS (8.3 versus 13.0). In patients with ON as onset manifestation of MS, the excess death rate was significantly higher in men (14.0) than in women (8.3). CONCLUSION: ON as onset manifestation of MS indicates a more favorable prognosis of survival of MS judged by excess death rate only in women.

Adolescent↗

A randomized trial of intravenous immunoglobulin in inflammatory demyelinating optic neuritis.

OBJECTIVE: To determine whether IV immunoglobulin (IVIg) reverses chronic visual impairment in MS patients with optic neuritis (ON). METHODS: In this double-blind, placebo-controlled Phase II trial, 55 patients with persistent acuity loss after ON were randomized to receive either IVIg 0.4 g/kg daily for 5 days followed by three single infusions monthly for 3 months, or placebo. RESULTS: The trial was terminated by the National Eye Institute because of negative results when 55 of the planned 60 patients had been enrolled. Fifty-two patients completed the scheduled infusions, and 53 patients completed 12 months of follow-up. Analysis of this data indicated that a difference between treatment groups was not observed for the primary outcome measure, improvement in logMAR visual scores at 6 months (p = 0.766). Exploratory secondary analyses suggested that IVIg treatment was associated with improvement in visual function (including logMAR visual scores at 6 months and visual fields at 6 and 12 months) in patients with clinically stable MS during the trial. CONCLUSIONS: IVIg administration does not reverse persistent visual loss from ON to a degree that merits general use.

Adult↗

The results of operation for ulnar neuritis.

The records of 110 cases of ulnar neuritis in 100 patients have been reviewed an average of 4.4 years after anterior transposition, or release of the aponeurosis. Seventy of the patients were reviewed personally. In over half the cases no precipitating cause was apparent. At operation the nerve was constricted by the flexor carpi ulnaris aponeurosis in fifty cases but in twenty-five no abnormal pathology was found. Recovery was greatest when operation was performed within three months of the onset of symptoms. In those cases where no abnormality was found, and those in which adhesions in the postcondylar groove involved the nerve, simple release was less effective than anterior transposition. It is therefore recommended that release be restricted to patients with a short history and with an obvious aponeurotic constriction unaccompanied by adhesions. Anterior transposition is the operation of choice where no abnormality is seen or where the nerve is dislocated, compressed or tethered proximal to the aponeurosis of flexor carpi ulnaris.

Adolescent↗

Suppression of experimental allergic neuritis with P2 protein of PNS myelin.

Experimental allergic neuritis was induced in the guinea pig with bovine PNS myelin. Treatment with P2 protein at the onset of the disease markedly reduced the severity of the clinical signs compared with untreated controls and animals treated with CNS myelin basic protein. The mortality was reduced from 94% in the combined control group to 50% in the treated group. Saline was a better vehicle for administration of the suppressive inoculation than incomplete Freund's adjuvant.

Animals↗

[Miller fisher syndrome and optic neuritis: case report].

We report a case of Miller Fisher syndrome and bilateral demyelinating optic neuropathy suggesting the possible involvement of central nervous system in this syndrome. The optic neuritis was confirmed by visual evoked potential.

Adult↗

Parsonage-Turner syndrome (acute brachial neuritis).

The cases of seven patients who had had acute brachial neuritis (Parsonage-Turner syndrome) were reviewed retrospectively. The patients had been followed for a mean of six years (range, three to ten years) after the onset of the symptoms. All patients had had an acute onset of intense pain in the shoulder without antecedent trauma. The pain decreased spontaneously and eventually resolved completely in all patients. Weakness in the shoulder had developed at a mean of approximately four weeks after the initial onset of pain. The weakness decreased spontaneously but very gradually in all patients; three patients had persistent, mild weakness at the most recent follow-up evaluation.

Acute Disease↗

Immunosuppressive effect of FK506 on experimental allergic neuritis in Lewis rats: change of T cell subsets.

The effect of a new immunosuppressant, FK506, on experimental allergic neuritis (EAN) was examined in Lewis rats. EAN was induced by inoculation with bovine peripheral myelin. The EAN rats were divided into two groups. FK506-treated EAN rats were prophylactically administered FK506 by injection into the peritoneal cavity at a dosage of 5.0 mg/kg/day for 13 days beginning the day after inoculation. The control EAN rats were injected with only saline solution. FK506 prevented the development of EAN, histologically and clinically. In FK506-treated EAN rats, flow cytometric analysis of T cell subsets of the lymph nodes showed a significant decrease in W3/13 positive T cells on the 14th and 21st day and a decrease in W3/25 positive T cells on the 21st day after inoculation when compared with the control EAN rats. The percentage of OX-8 positive T cells were not significantly different between the two groups. Our results suggest that FK506 prevented the development of EAN by decreasing W3/13 and W3/25 positive T cells.

Animals↗

The two-color analysis of the T-lymphocyte subsets in experimental allergic neuritis in rats.

We examined the T-cell subsets in the peripheral blood, spleen and lymph nodes during the course of experimental allergic neuritis (EAN) by using two-color analysis. In the acute phase, the percentages of CD4+ major histocompatibility complex (MHC)-II+ cells and CD8+ MHC-II+ cells in the lymph nodes of EAN rats were significantly higher than in the control rats. In the recovery phase, the percentage of CD4+ CD45RC+ cells and CD8+ CD45RC+ cells in the lymph nodes in EAN rats were significantly higher than in the control rats. However, significant changes of the T-cell subsets were not detected in either the spleen or the peripheral blood during the course of EAN. These results suggest that CD4+ MHC-II+ cells, CD8+ MHC-II+ cells, CD4+ CD45RC+ cells and CD8+ CD45RC+ cells may play a role in the course of EAN. The relationship between these double staining cells and EAN is discussed.

Analysis of Variance↗

[Bartonella henselae as a cause of optical nerve neuritis].

INTRODUCTION: Bartonella henselae is included into the group of gram-negative bacteria that can cause not so rare disease known as cat-scratch disease (CSD). This disease is characterized by the specific general symptoms, and the complications in the eyes can be manifested in the form of neuroretinitis, follicular conjunctivitis and focal chorioretinitis. In this paper clinical and epidemiological characteristics of a patient with ophthalmologic complications caused by Bartonella henselae are described. We indicate diagnostic possibilities and the criteria for making the diagnosis. CASE REPORT: We presented a 42-year-old female patient with CSD symptoms, and with a registered neuritis as an ophthalmologic complication. Two weeks after the occurrence of a scratch on the hand after the contact with a cat, there was a slight lymphadenopathy of the axial area of the left side, accompanied by light febrility and weakness. A week after these symptoms occuring, the patient complained of a reduction of the visual acuity in her left eye. The established visual acuity in the left eye was 0.1 with ophthalmological findings of a light edema of the optical disk and a partial star-like edema in the nasal half of the macula. Central scotoma was present, with the extension of the blind spot and the constriction of central isopter of the left eye visual field. Fluorescein biomicroscopy revealed an intensive leaking of fluoresceins at the level of optical disk and macular region in an early arterial phase, without the appearance of pathological phenomena at the level of retinal blood vessels. With the application of doxycyline 100 mg two times a day, and systemic application of prednisolone (at the initial doses of 120 mg), after a two-week period, there was a full recovery of the visual acuity, out the optical disk edema, and the presence of light edema in the left eye macula receded. The complete disappearance of the edema in the macula was registered four weeks following the application of the therapy. CONCLUSION: Cat-scratch disease can be recognized by means of characteristic general symptoms, and it must be considered in persons with ophthalmologic picture of neuroretinitis. In spite of the good prognosis for the general condition of a patient, it is advised to apply antibiotic therapy in the cases where ophthalmologic complications appear. We recommend the application of doxycyline 100 mg two times a day, for a month. When pronounced edema of the optical disk and edema in the macula are present, a systematic application of corticosteroids is necessary.

Adult↗

Mycobacterial neuritis in a cat.

A 2-year-old spayed female domestic shorthair cat was referred for evaluation of rapidly progressive lameness of the right hind limb, which was paralyzed. Histologic examination of biopsy specimens revealed pyogranulomatous inflammation affecting the sciatic, common peroneal, and tibial nerves, and slender, beaded, acid-fast bacilli within macrophages, nerve fibers, and degenerate axons. A diagnosis of mycobacterial neuritis was made and the cat was treated with clofazimine and enrofloxacin for extended periods. Treatment was partially effective; the goal of returning normal function to the limb was not achieved, but disease progression was halted and the cat remained a viable pet.

Alanine Transaminase↗

Audio-vestibular findings in patients with vestibular neuritis.

19 patients with the clinical diagnosis vestibular neuritis, i.e., cases with unilaterally ENG verified abolished or reduced caloric reactions but without symptoms of central nervous involvement or hearing impairment, participated in the study. In addition to ENG examinations and Békésy audiometry all patients were submitted to stapedius reflex tests and auditory brainstem response examinations (ABR) for signs of subclinical auditory nerve engagement. In all but one of the 19 patients the caloric reactions improved; 8 of the 13 patients available for tests after one year recovered completely. The ABR was normal in all cases but the stapedius reflex thresholds were pathologically elevated and remained so in about half of the subjects throughout the observation time; reflex decay was not present in anyone. Cases with pathologically elevated stapedius reflex thresholds showed a tendency to slower recovery of the vestibular function than the group with the normal reflexes. The results were interpreted to indicate lack of eighth nerve or CNS engagement. The possibility that subjects with reflex threshold elevation may constitute a group with constitutional weakness of the audio-vestibular apparatus disposed for vestibular disease is discussed.

Adult↗

Experimental vestibular neuritis induced by herpes simplex virus.

An animal model of vestibular neuritis was developed by inoculating herpes simplex virus type 1 (HSV-1) in the auricle of a mouse. Deviation of the body was observed in 4 of 30 mice 6 days after inoculation. These animals were sacrificed 6 to 10 days after inoculation and the vestibular nerve was examined histopathologically and immunohistochemically. The HSV-1 antigens were recognized exclusively in Scarpa's ganglion of the vestibular nerve in 2 of 4 mice in which signs of vestibular involvement were manifested.

Animals↗

Herpetic vestibular neuritis: an experimental study.

An animal model of vestibular neuritis was developed by inoculating herpes simplex virus type 1 (HSV-1) into the auricle of mice. Postural deviation was observed in 5 of 99 mice at 6 to 8 days after inoculation. Following evaluation of the vestibular function, the animals were sacrificed and the vestibular nerves examined for histopathology and immunohistochemically. All mice developed postural deviation, presented as abnormal behaviour; they could not perform various vestibular tasks, such as gait, traversing a narrow path, climbing a rope, negative geotaxis, grasping a rod, and swimming. Degeneration of Scarpa's ganglion was observed in 4 of 5 mice that developed postural deviation, while HSV-1 antigens were found in 2 of them. No such histological findings were seen in animals with normal vestibular function.

Animals↗

Unilateral vestibular neuritis with otolithic signs and off-vertical axis rotation.

Off-vertical axis rotation (OVAR) at constant velocity is a dynamic otolith stimulus that induces horizontal and vertical eye movement responses. To determine the value of this examination as a test for unilateral otolithic hypofunction, we compared the OVAR responses of patients suffering from acute vestibular neuritis (VN) without any sign of otolith affection, with those of patients suffering from acute VN with otolithic signs. The horizontal eye movement bias component shows directional preponderance (DP) significantly higher in patients with otolithic signs than in patients not presenting them. However, as bias DP also reflects the imbalance between right and left horizontal canals activity, this greater bias DP could be explained by the more severe canals impairment-evaluated by caloric test-found in patients with otolithic signs. No significant difference can be shown on horizontal modulation. The DP of vertical modulation is significantly higher in patients presenting otolithic signs than in patients not presenting them: in the case of otolithic signs, the responses are smaller during rotations toward the affected side. Therefore, this variable could be used as an indication of unilateral otolithic hypofunction.

Adult↗

Soluble complement receptor 1 (sCR1) is not as effective as cobra venom factor in the treatment of experimental allergic neuritis.

To further investigate the role of complement activation in Experimental Allergic Neuritis (EAN), the effect of systemic complement blockade by soluble CR1 (sCR1) was compared to complement depletion by Cobra Venom Factor (CVF) in EAN rats immunized with bovine peripheral nerve myelin. EAN rats treated with CVF (n = 10) had significantly reduced clinical scores compared to rats treated with sCR1 (n = 9) or saline (n = 10) (score: sCR1 0.66 +/- 0.7; CVF 0; saline 0.6 +/- 0.8; mean +/- SD). CVF treatment more effectively decreased inflammation and demyelination compared to sCR1 treatment which had only a partial effect (inflammation: sCR1 1.8 +/- 1.4; CVF 0.3 +/- 0.7; saline 1.9 +/- 1.2; demyelination; sCR1 1.3 +/- 1; CVF 0.1 +/- 0.6; saline 1.7 +/- 1.2). In lumbosacral nerve roots significantly less infiltrating ED1 positive macrophages and CD11bc (expressing complement receptor 3 or CR3) positive inflammatory cells were present in CVF treated EAN rats while there was a limited decrease in inflammation in the sCR1 treated animals compared to the saline treated rats (ED1: sCR1 1.4 +/- 1.2; CVF 0.5 +/- 0.6; saline 1.7 +/- 1.2; CD11bc: sCR1 1.9 +/- 1.2; CVF 0.9 +/- 1; saline 2.1 +/- 1.2). Our findings suggest that complement depletion by CVF is more effective than complement blockade by sCR1 in reducing the severity of inflammatory peripheral nerve demyelination.

Animals↗

Antioxidant enzyme suppression of demyelination in experimental optic neuritis.

Detoxification of hydrogen peroxide by the antioxidant enzyme catalase suppressed the neurologic manifestations of acute experimental allergic encephalomyelitis (EAE) and prevented death of treated adult strain-13 guinea pigs. The oxygen radical scavenger superoxide dismutase (SOD) delayed the onset of paralysis by one day, but did not prevent death from encephalomyelitis common to most of this group and all untreated animals. Histopathologic analysis of the optic nerves confirmed a statistically significant reduction in demyelination with catalase treatment, but not with SOD. Hydrogen peroxide, and/or its conversion products, discharged by phagocytic mononuclear cells, may play a role in the pathogenesis of demyelination in experimental optic neuritis.

Animals↗

Protective effect of Rolipram in experimental autoimmune neuritis: protection is associated with down-regulation of IFN-gamma and inflammatory chemokines as well as up-regulation of IL-4 in peripheral nervous system.

Rolipram, a phosphodiesterase type 4 inhibitor, is reported to have anti-inflammatory effects. It can markedly downregulate antigen-driven T cell proliferation and suppress TNF-(alpha and TNF-beta production in vitro and in vivo, which have led to its use in the treatment of a number of autoimmune disorders including experimental autoimmune encephalomyelitis (EAE) and experimental autoimmune neuritis (EAN). EAN is a CD4+ T cell-mediated demyelinating autoimmune disease of peripheral nervous system (PNS) that represents an animal model for the study of the immunopathogenesis and immunotherapy of Guillain-Barré syndrome (GBS) in human. In the previous study, we reported that suppression of EAN by Rolipram was associated with down-regulated myelin antigen-induced T cell responses as well as downregulated IFN-gamma and TNF-alpha production. Here we report that EAN induced in Lewis rats by inoculation with the PNS P2 protein peptide 57-81 and Freund's complete adjuvant (FCA), was strongly suppressed by Rolipram administered twice daily intraperitoneally from day 9 post immunization (p.i.), i.e. after onset of clinical EAN to day 18 p.i. This clinical effect was associated with dose-dependent down-regulated production of IFN-gamma and the chemokines macrophage inflammatory protein-1 alpha (MIP-1 alpha, MIP-2 and monocyte chemotactic protein-1(MCP-1) as well as up-regulated IL-4 production in sciatic nerve sections from Rolipram-treated EAN rats at maximum of clinical EAN, i.e. on day 14 p.i.. These findings suggest that Rolipram may be useful in certain T cell-dependent autoimmune diseases and inflammatory neuropathies. These observations call for further studies on the potential role of Rolipram in the treatment of autoimmune diseases.

Animals↗

Influence of K+ channel openers on interferon-gamma dependent immune response in experimental allergic neuritis (EAN).

We examined the influence of the K+ channel opening drugs BRL 38227, pinacidil and diazoxide on cellular immune response and clinical course of experimental allergic neuritis (EAN) actively induced in Lewis rats by bovine peripheral myelin (BPM). T cell functions of EAN lymph node cells were assessed by measurement of proliferation and by counting of interferon-gamma secreting cells (IFN-gamma sc) in response to the specific antigen BPM and the T cell mitogen phytohemagglutinin (PHA). BRL 38227 and diazoxide at concentrations of 10(-5)M-10(-6)M and pinacidil at concentrations of 10(-5)M-10(-7)M enhanced the proliferative response to both BPM and PHA. The number of IFN-gamma sc was suppressed by the K+ channel openers in the same concentration range. There was a tendency of stronger suppression of cultures with high numbers of BPM-reactive IFN-gamma sc than of cultures with low numbers of BPM-reactive IFN-gamma sc. The applied K+ channel openers are primarily acting on ATP-sensitive K+ channels, which have not been found in T cells so far. The drugs may, therefore, exert non-selective effects on conventional voltage- and/or Ca(++)-dependent channels of T cells. A first trial with in vivo administration of 2.5 mg/kg x day of the drugs resulted in more severe neurological deficits in the early phase of EAN with BRL 38227, whereas pinacidil and diazoxide had no significant effects.

Animals↗