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Inflammatory Disorders of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Favorable factors for long-term survival free of disability: Early age of onset.Female sex.Sensory dysfunction (paresthesia) at onset.Relapsing–remitting clinical course.Longer interattack interval.Low initial RR.Fewer lesions on baseline MRI.CSF oligoclonal band negative.
Neurology
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
There are three main patterns of MS: Relapsing–remitting MS (85% of patients): Episodes of symptoms are followed by recovery and periods of stability. There may be residual damage to parts of the CNS that results in only a partial recovery during remissionsSecondary progressive MS: Occurs typically 15–20 years after onset of relapsing–remitting MS with gradual worsening of neurological function, with or without continued relapsesPrimary progressive MS (10%–15% of patients): There is a steady gradual worsening of the disease from the onset, without remissions
Dopamine in the Immune and Hematopoietic Systems
Published in Nira Ben-Jonathan, Dopamine, 2020
MS is a chronic disease that leads to a progressive neurological disability and is caused by an autoimmune response against the myelin sheath of axons in different areas of the brain and spinal cord. It mainly afflicts young adults, with a prevalence of 58.3 per 100,000 individuals, affecting about 2.4 million persons worldwide. MS risk-conferring genes, together with environmental risk factors (i.e., smoking and infectious agents), account for the development and progression of the diseases. The course of MS and its symptomatology are heterogeneous and include impairments of visual sensory, motor, cognitive, and autonomic functions. The most common form is the relapsing/remitting MS, characterized by alternating phases: a neurological impairment and inflammation, followed by a remission period of clinical recovery.
Restless legs syndrome and related factors in people with multiple sclerosis in Turkey
Published in Neurological Research, 2022
Asiye Tuba Ozdogar, Ozge Ertekin, Turhan Kahraman, Cavid Baba, Serkan Ozakbas
Even recent reviews [5,9] have proven that the prevalence of restless legs syndrome is higher in pwMS than in the general population, essential data on which factors associated with MS disease increase the risk of developing this phenomenon is still questioning. Also, though restless legs syndrome has a higher incidence in females, older individuals, and people with a family history of restless legs syndrome in the general population, there is no firm evidence that this pattern valid in pwMS [9–11]. Some studies have reported that restless legs syndrome is associated with disease duration [10,12,13], yet, some studies do not confirm this association [11,14]. Douay et al. reported that restless legs syndrome was more common in the subtype of relapsing-remitting MS [14]. On the contrary, Manconi et al. showed that restless legs syndrome was rather prevalent in the primer-progressive than relapsing-remitting MS [10]. There is no clear evidence of gender, body mass index, age, disease duration, disability level, or type of MS is related or not with the presence of restless legs syndrome and its severity. In the light of this uncertainty, we aimed to determine possible explanations of the occurence and severity of restless legs syndrome in pwMS, considering persons without MS as a control group. Also, to look at how features related to MS influence the frequency of occurring of restless legs syndrome symptoms.
Understanding and managing autonomic dysfunction in persons with multiple sclerosis
Published in Expert Review of Neurotherapeutics, 2021
Ivan Adamec, Magdalena Krbot Skorić, Mario Habek
One of the most important characteristics of early stages of relapsing remitting MS is that symptoms may fluctuate over time. Similarly changes in cardiovascular AD in pwMS occur during the course of the disease. In a group of 121 people diagnosed with clinically isolated syndrome followed over two years 47.3% had either worsening or improvement in sympathetic adrenergic function while in 90% of people with clinically isolated syndrome there was no change in parasympathetic nervous system tests [24]. The total number of T2 lesions was found to be an independent predictor for worsening of symptomatic dysautonomia. There is also a difference in cardiovascular AD burden in patients with relapsing remitting and progressive types of MS. Patients with progressive types of MS have a higher autonomic symptom burden and have more pronounced AD on formal testing [25,26]. It appears that there is a two-way interaction between AD and MS activity as autonomic symptom burden seems to predict disease activity in early multiple sclerosis [27]. Furthermore, patients with clinically isolated syndrome who have PoTS convert earlier to clinically definite MS [28].
Patient and neurologist preferences in the UK for relapsing–remitting multiple sclerosis treatments: findings from a discrete choice experiment
Published in Current Medical Research and Opinion, 2021
Tom Tencer, Oliver Will, Jinender Kumar, M. Janelle Cambron-Mellott, deMauri S. Mackie, Kathleen Beusterien
Multiple sclerosis (MS) is a chronic inflammatory disease that impairs the functioning of the central nervous system and causes neurologic disabilities1. MS is estimated to affect more than 2 million people worldwide, including 130,000 people in the United Kingdom2. The most common symptoms of MS include fatigue, chronic pain, mobility problems and cognitive impairment3, and the disease is most often identified during early adulthood between the ages of 20 and 50 years4. Relapsing–remitting MS (RRMS) is the most frequently encountered form of the disease and is characterized by temporary periods of worsening neurologic function (i.e. relapses, flare-ups or exacerbations), followed by partial or complete recovery periods (i.e. remissions)1,5. Each patient’s disease course is unique and can vary with regard to their symptoms, rate of progression and response to treatment6.