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Demyelinating syndrome
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Jeffrey Hernandez, Leticia Tornes, Janice Y. Maldonado
Two other disease courses have been described that were both present in our clinical case. These are disease courses seen prior to the diagnosis of CDMS. Clinically Isolated Syndrome (CIS): CIS is the first clinical presentation of RRMS and usually presents as a syndrome: unilateral optic neuritis, transverse myelitis, or a brainstem attack (Miller et al., 2005). Patients with CIS and an abnormal brain MRI are likely to develop clinically definite MS (CDMS) (Fisniku et al., 2008).Radiologically Isolated Syndrome (RIS): May be considered a presymptomatic phase of MS, usually an incidental image finding highly suggestive of an inflammatory demyelinating disease, in the absence of clinical signs and symptoms of MS. Patients should be closely monitored (Lublin et al., 2014).
Neurocognitive impairment and social cognition in multiple sclerosis
Published in International Journal of Neuroscience, 2022
Triantafyllos Doskas, George D. Vavougios, Panagiota Karampetsou, Constantinos Kormas, Emmanouil Synadinakis, Konstantina Stavrogianni, Pinelopi Sionidou, Aspasia Serdari, Theofanis Vorvolakos, Ioannis Iliopoulos, Κonstantinos Vadikolias
Multiple sclerosis (MS) is a chronic debilitating heterogeneous immune-mediated disease that affects mainly adults and young people [1–4]. Based on clinical course, it is sub-grouped in clinically-isolated syndrome (CIS), which may not necessarily progress to clinically-definite MS, relapsing-remitting (RRMS), primary progressive (PPMS) and secondary progressive (SPMS). Approximately, 85% of MS patients are initially diagnosed with RRMS with the majority progressing to SPMS, in which there is a progressive deterioration of neurologic function over time [5]. PPMS is associated with continuous and gradual worsening of symptoms with no distinct exacerbation or remission [3,6]. Apart from these phenotypes, radiologically-isolated syndrome (RIS) may appear in asymptomatic patients with incidental MRI findings suggestive of MS [4]. MS is associated with broad inter- and intra-individual heterogeneity regarding clinical features, genetics, pathogenesis, progression, tissue-repair, plasticity, and responsiveness to treatment [4]. Although the definition and the existence of benign MS (BMS) is a matter of debate, its prevalence ranges from 6%-64% among MS patients [3,7,8]. In approximately 3-10% of patients, MS onset occurs before the age of 16 years (early-onset MS, EOMS) [9–11]. Both paediatric- and adult-onset MS (POMS, AOMS) have similar pathogenic mechanisms, but POMS has distinctive features and presents almost exclusively as RRMS [12–14].
High leukocyte-to-lymphocyte ratio is associated with acute relapse in multiple sclerosis patients
Published in Neurological Research, 2022
Jinli Mahe, Lei Wang, Kai Guo, Xiaoming Liu, Xuejiao Zeng, Lipeng Jing
The strength of the present study is that it was based on a cheap and prevalently used CBC test for MS in clinical practice. There were some limitations in this study. First, the causality between the LLR and MS could not be confirmed owing to the case-control design of this study. Further prospective investigations on the LLR may provide further insights regarding its association with MS. Second, MS was diagnosed by two clinical physicians using only MRI and symptom data without CSF oligoclonal bands, which may have led to misdiagnoses. This might have led to underestimations of the association between the LLR and MS. In addition, the 2010 McDonald criteria cannot discriminate MS from some CNS diseases with similar pathologies and clinical symptoms, such optic neuromyelitis, clinically isolated syndrome, and radiologically isolated syndrome. Finally, the sample size was a bit small in this study. However, a matched case-control study was used to improve the study efficiency.
The Effect of Radiologically Isolated Syndrome on Retinal and Choroidal Hemodynamics – An Optical Coherence Tomography Angiography Study
Published in Current Eye Research, 2022
Büşra Yılmaz Tuğan, Sena Destan Bünül
Radiologically isolated syndrome (RIS) is defined as the detection of multiple sclerosis (MS)-like lesions in the magnetic resonance imaging (MRI) examination, which is usually performed for another reason, without any symptoms. In the follow-up of RIS, it was observed that approximately one-third of them turned into MS. Therefore, in some studies, RIS is considered to be a precursor to MS.1 It is known that cerebral hypoperfusion and vascular pathologies are pathological processes that play a role in the etiology of MS.2 Several risk factors for conversion to MS such as male sex, younger age, MRI lesion burden, brain and cord lesions, oligoclonal bands, and neurofilament light chain in cerebrospinal fluid have been identified.3–7 However, the discovery of new prognostic biomarkers is still required.