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By EFRAIN PAEZ Internal Medicine since 1988. Interested in all aspects of Medicine.
R Deschamps, A Gueguen, A Lecler, K Lecouturier, C Lamirel, C Bensa, R Marignier, C Vignal, O Gout
BACKGROUND AND PURPOSE: Few recent data are available concerning idiopathic optic neuritis (ON). We aimed to describe a large cohort of patients with idiopathic ON. We compared this cohort with patients with ON related to myelin oligodendrocyte glycoprotein (MOG) or ON related to aquaporin-4 (AQP4) antibodies. METHODS: This was a monocentric retrospective observational study. Inclusion criteria for idiopathic ON were as follows: age ≥ 16 years, follow-up of at least 2 years, negative for antibodies against MOG and AQP4 immunoglobulin G, and no magnetic resonance imaging (MRI) lesions suggestive of demyelination (two brain MRI scans, one at baseline and one during follow-up, and one spinal cord MRI scan)...
November 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Ethan Meltzer, Sashank Prasad
Optic neuritis remains a common diagnosis with controversial management. Although typical optic neuritis is often associated with "good" recovery of visual acuity, patients are often left with persistent impairments of contrast sensitivity, color vision, and visual field. These permanent visual deficits correlate with structural injury to the anterior visual pathway and are closely linked to visual quality of life. High dose corticosteroids are commonly used for patients with acute optic neuritis...
July 2018: Asia-Pacific Journal of Ophthalmology
Roman Kassa, Flavius Raslau, Charles Smith, Padmaja Sudhakar
No abstract text is available yet for this article.
January 2, 2018: Neurology
A Tejeda-Velarde, L Costa-Frossard, S Sainz de la Maza, Á Carrasco, M Espiño, C Picón, I Toboso, P E Walo, D Lourido, A Muriel, J C Álvarez-Cermeño, L M Villar
BACKGROUND AND PURPOSE: Different biological and radiological biomarkers predict clinical conversion to multiple sclerosis (MS) after a clinically isolated syndrome (CIS). The aim was to explore their role in predicting the outcome of patients with optic neuritis (ON), a CIS considered to have a benign prognosis. METHODS: Sixty-eight consecutive ON patients were followed prospectively. Magnetic resonance imaging (MRI) and cerebrospinal fluid studies including oligoclonal immunoglobulin G (IgG) bands (OCGBs), lipid-specific oligoclonal IgM bands (LS-OCMBs) and neurofilament light chain quantification were performed at disease onset...
April 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Sung-Min Kim, Seong-Joon Kim, Haeng Jin Lee, Hiroshi Kuroda, Jacqueline Palace, Kazuo Fujihara
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system (CNS) mostly manifesting as optic neuritis and/or myelitis, which are frequently recurrent/bilateral or longitudinally extensive, respectively. As the autoantibody to aquaporin-4 (AQP4-Ab) can mediate the pathogenesis of NMOSD, testing for the AQP4-Ab in serum of patients can play a crucial role in diagnosing NMOSD. Nevertheless, the differential diagnosis of NMOSD in clinical practice is often challenging despite the phenotypical and serological characteristics of the disease because: (1) diverse diseases with autoimmune, vascular, infectious, or neoplastic etiologies can mimic these phenotypes of NMOSD; (2) patients with NMOSD may only have limited clinical manifestations, especially in their early disease stages; (3) test results for AQP4-Ab can be affected by several factors such as assay methods, serologic status, disease stages, or types of treatment; (4) some patients with NMOSD do not have AQP4-Ab; and (5) test results for the AQP4-Ab may not be readily available for the acute management of patients...
July 2017: Therapeutic Advances in Neurological Disorders
Elena Sherman, May H Han
Neuromyelitis optica and neuromyelitis optica spectrum disorder (NMO/NMOSD) is a rare but clinically aggressive demyelinating disease of the central nervous system (CNS) caused by antibodies against water channel protein aquaporin 4 (AQP4) in the astrocytic foot processes. Patients typically present with optic neuritis (ON) or longitudinally extensive transverse myelitis (LETM). The majority of patients with NMOSD show good response to treatment with steroids and plasmapheresis in the acute setting; however, 90 % of patients will eventually have clinical relapses and accrue permanent disability...
November 2015: Current Treatment Options in Neurology
Anna Jurewicz, Krzysztof Selmaj
No abstract text is available yet for this article.
March 2015: Clinical Neurology and Neurosurgery
Benjamin M Greenberg, Elliot M Frohman
PURPOSE OF REVIEW: This article presents data about inflammatory myelopathies, also referred to as transverse myelitis. While the idiopathic form of this condition is rare, the prevalence of transverse myelitis is relatively common when including all of the secondary causes, such as multiple sclerosis (MS). Thus, clinicians and researchers should be familiar with the presentations, diagnostic algorithms, treatment options, and long-term symptom management for patients with transverse myelitis...
February 2015: Continuum: Lifelong Learning in Neurology
José M Láinez-Andrés, Francisco Gascón-Giménez, Francisco Coret-Ferrer, Bonaventura Casanova-Estruch, José M Santonja
INTRODUCTION: Plasma exchange is a technique used in the treatment of some neurological autoimmune disorders since the 80s, especially in acute conditions. In recent years new data about it use has been published in many diseases with autoimmune basis, expanding the range of use of this technique. AIM: To update the current indications of this technique in the treatment of neurological diseases. DEVELOPMENT: We conducted a thorough review of all articles about the efficacy of plasma exchange in the treatment of different neurological diseases published since the 80s...
February 1, 2015: Revista de Neurologia
Hicham El Otmani, Fatima Dany, Bouchra El Moutawakil, Mohammed Abdoh-Rafai, Ilham Slassi
No abstract text is available yet for this article.
December 2015: Acta Neurologica Belgica
M J Fernández-Megía, B Casanova-Estruch, F Pérez-Miralles, J Ruiz-Ramos, C Alcalá-Vicente, J L Poveda-Andrés
INTRODUCTION: Neuromyelitis optica is an inflammatory and usually relapsing demyelinating autoimmune disease of the central nervous system that targets the optic nerves and spinal cord. Rituximab has been used for different neurological diseases that are probably immune-mediated or involving humoural immunity. The objective of this study is to evaluate the efficacy and safety of rituximab as treatment for neuromyelitis optica in a tertiary hospital. METHODS: Retrospective study of patients with neuromyelitis optica treated with rituximab 1000mg on days 1 and 15, repeated every 6 to 8 months...
October 2015: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Kuo-Hsuan Chang, Long-Sun Ro, Rong-Kuo Lyu, Chiung-Mei Chen
Neuromyelitis optica (NMO) is an acquired, heterogeneous inflammatory disorder, which is characterized by recurrent optic neuritis and longitudinally extensive spinal cord lesions. The discovery of the serum autoantibody marker, anti-aquaporin 4 (anti-AQP4) antibody, revolutionizes our understanding of pathogenesis of NMO. In addition to anti-AQP4 antibody, other biomarkers for NMO are also reported. These candidate biomarkers are particularly involved in T helper (Th)17 and astrocytic damages, which play a critical role in the development of NMO lesions...
February 2, 2015: Clinica Chimica Acta; International Journal of Clinical Chemistry
Amina Malik, Maryam Ahmed, Karl Golnik
CONTEXT: Optic neuritis (ON) is defined as inflammation of the optic nerve and can have various etiologies. The most common presentation in the US is demyelinating, or "typical" ON, usually associated with multiple sclerosis. This is in contrast to "atypical" causes of ON, which differ in their clinical presentation, management, and prognosis. These atypical cases are characterized by lack of eye pain, exudates, and hemorrhages on exam, very severe, bilateral or progressive visual loss, or with failure to recover vision...
October 2014: Indian Journal of Ophthalmology
Kazuo Fujihara, Jacqueline Palace
Neuromyelitis optica spectrum disorders (NMOSD) can mimic multiple sclerosis (MS). Avoiding misdiagnosis is crucial, because some disease-modifying drugs for MS can aggravate NMOSD, causing blindness and paraplegia. A recent study reports that misdiagnosis of NMOSD as MS occasionally occurs, and that a two-step antibody assay could improve differential diagnosis.
December 2014: Nature Reviews. Neurology
Wei-Chia Tsao, Rong-Kuo Lyu, Long-Sun Ro, Ming-Fen Lao, Chiung-Mei Chen, Yih-Ru Wu, Chin-Chang Huang, Hong-Shiu Chang, Hung-Chao Kuo, Chun-Che Chu, Kuo-Hsuan Chang
BACKGROUND: Motor and somatosensory evoked potentials (MEPs and SSEPs) are sensitive tools for detecting subclinical lesions, assessing disease severity, and determining the prognosis for outcomes of patients with inflammatory neurological diseases such as multiple sclerosis. However, their roles in neuromyelitis optica (NMO), a severe inflammatory neurological disease that predominantly involves optic nerves and spinal cord, have not yet been clarified. METHODS AND FINDINGS: Clinical symptoms and examination findings at relapses of 30 NMO patients were retrospectively reviewed...
2014: PloS One
M Sato, K Sugiyama, T Kondo, S-I Izumi
STUDY DESIGN: Single case report. OBJECTIVE: We present a case of paraplegia due to neuromyelitis optica (NMO) with poor rehabilitation outcome. SETTING: University hospital, Japan. CASE REPORT: A 27-year-old woman with NMO presented with T5 paraplegia of ASIA impairment scale grade A. Spinal cord magnetic resonance imaging revealed a lesion spanning C3 to L1 level. After acute phase treatment, flaccid paraplegia below T5 and a T2-weighted hyperintense lesion from T6 to T10 level remained...
November 2014: Spinal Cord
Markus Krumbholz, Edgar Meinl
B linage cells are versatile players in multiple sclerosis (MS) and neuromyelitis optica/neuromyelitis optica spectrum disorder (NMO). New potential targets of autoantibodies have been described recently. Pathogenic mechanisms extend further to antigen presentation and cytokine production, which are increasingly recognized as therapeutic targets. In addition to pro-inflammatory effects of B cells, they may act also as anti-inflammatory via production of interleukin (IL)-10, IL-35, and other mechanisms. Definition of regulatory B cell subsets is an ongoing issue...
May 2014: Seminars in Immunopathology
George Tackley, Wilhelm Kuker, Jacqueline Palace
Neuromyelitis optica (NMO), or Devic's disease, is a rare demyelinating disorder of the central nervous system that has a predilection for the optic nerve and spinal cord. Magnetic resonance imaging (MRI) is required to diagnose NMO. Longitudinally extensive transverse myelitis is NMO's imaging hallmark and the presence of a brain MRI that is not diagnostic of multiple sclerosis (MS) also remains part of the diagnostic criteria. It is increasingly recognised that MS and NMO brain imaging can, however, have similar appearances but differences do exist: hypothalamic, periaqueductal grey and area postrema lesions implicate NMO whilst cortical, U-fibre or Dawson's finger lesions are suggestive of MS...
August 2014: Multiple Sclerosis: Clinical and Laboratory Research
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