By Paul S. Giacomini
This handbookis a set of scientific narratives that underscore the heterogeneous and unpredictable presentation of a number of sclerosis (MS) and provides real-world medical context to fresh drug advancements. This obtainable and concise book is meant for use by way of a variety of doctors, from professional neurologists to scientific trainees with an curiosity in neurology. an excellent medical source, Case reviews in a number of Sclerosis presents an evidence-based dialogue of every case, with an objective to augment potent analysis and therapy of sufferers with MS and MS-related conditions.
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Natalizumab: alpha 4-integrin antagonist selective adhesion molecule inhibitors for MS. Expert Rev Neurother. 2004;4:571-580. Polman CH, O’Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH, et al. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2006;354:899-910. Rudick RA, Stuart WH, Calabresi PA, et al. Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med. 2006;354:911-923. Bloomgren G, Richman S, Hotermans C, et al.
Thus, disease activity as seen on MRI in a patient on immunomodulatory therapy represents a measure of treatment response. Though MRI changes should be viewed in the appropriate clinical context, new T2 or gadolinium-enhancing lesions may warrant initiating a discussion regarding treatment optimization, and in some cases may trigger a treatment change even in the absence of a new overt clinical relapse. Uhthoff’s phenomenon Many people with MS and other neurological demyelinating disorders experience a worsening of neurologic symptoms associated with overheating.
C A S E 6: P R O G R E S S I V E M U LT I F O C A L L EU KO E N C E P H A LO PAT H Y • 49 References 1 2 3 4 5 6 7 8 9 10 11 12 13 Cordioli C, De Rossi N, Rasia S, Lodoli G, Capra R. Early detection and favourable outcome of natalizumab-related progressive multifocal leukoencephalopathy (PML) in two multiple sclerosis patients. Neurol Sci. 2015;36:489-491. Wattjes MP, Barkhof F. Diagnosis of natalizumab-associated progressive multifocal leukoencephalopathy using MRI. Curr Opin Neurol. 2014;27:260-270.
