Presentation
The prospective cohort comprised patients presenting to the neuroimmunology clinic for MS or other DD of 5-year-duration or less. [mdsabstracts.org]
Case Presentation A 26-year-old previously healthy man presented to the emergency department with rapidly progressing upper and lower extremity weakness that developed following episodes of pain and tingling. [jaocr.org]
The criteria proposed by Paty et al (10) define imaging findings as definitely abnormal when four or more lesions are present or when at least three lesions, one of which is in a periventricular location, are present. [ajnr.org]
ALS Feature CSM ALS Age Older than 55 Older than 55 MRI findings Spondylosis Spondylosis Fasciculations Absent Present Atrophy of arms Present Present Atrophy of legs Absent Present Denervation Absent Present Other conditions that can mimic CSM on presentation [aafp.org]
Cord expansion may or may not be present; it was found in 47% in published series. [radiologykey.com]
Entire Body System
- Malnutrition
Cortical thrombophlebitis occurs primarily in children suffering from malnutrition and dehydration, but it also may result from some blood diseases and may occur in pregnancy. [britannica.com]
- Chills
Seek immediate medical care if you experience any warning signs or symptoms, including: Sudden weakness or paralysis Sudden vision change or loss of vision Slurred speech Fever, chills, headache and/or neck stiffness Difficulty breathing or shortness [livestrong.com]
- Arm Pain
Symptoms often develop insidiously and are characterized by neck stiffness, arm pain, numbness in the hands, and weakness of the hands and legs. [aafp.org]
- Cerebral Palsy
Cerebral palsy The term cerebral palsy encompasses all of the conditions that damage the brain around or before the time of birth—other than developmental causes. [britannica.com]
Skin
- Sweating
Other complications that may result from a spinal cord injury are an inability to regulate blood pressure, low blood pressure, reduced control of body temperature, an inability to sweat that occurs below the level of injury, and chronic pain. [my-ms.org]
Autonomic nerve damage is common in patients with urinary retention, urinary obstacles, and sweating dysfunction. [nrronline.org]
Musculoskeletal
- Muscular Atrophy
Degenerative nerve diseases include Alzheimer's disease Amyotrophic lateral sclerosis Friedreich's ataxia Huntington's disease Lewy body disease Parkinson's disease Spinal muscular atrophy Degenerative nerve diseases can be serious or life-threatening [icdlist.com]
Muscular atrophy was observed in 11 patients, but there were no eyesight or hearing disorders. [nrronline.org]
Charcot-Marie-Tooth disease (also known as peroneal muscular atrophy because of the special involvement of shin muscles) is a genetically acquired demyelinating neuropathy. [britannica.com]
- Neck Pain
Finding a myelin-damaging condition in the average back or neck pain patient is very rare. [cure-back-pain.org]
Neurologist mentioned the demyelination being MS but without a lumbar puncture couldn't confirm it but said the back pain was not connected to my neck pain as first thought but he wanted an MRI of my back, and he referred me to neurosurgeon but stressed [patient.info]
- Arm Weakness
She had a history of febrile disease one month before, acute onset of paraplegia, diplopia, progressive arm weakness and dyspnea. Her consciousness was not impaired. [bmcresnotes.biomedcentral.com]
Psychiatrical
- Self-Mutilation
[…] the basal ganglia of the brain that produce rigidity, weakness, and abnormal movements; Lesch-Nyhan syndrome, which results in raised levels of uric acid in the blood, abnormal movements, spastic weakness, intellectual disability, and a tendency to self-mutilate [britannica.com]
Neurologic
- Stroke
Sometimes the cause is a medical condition such as alcoholism, a tumor, or a stroke. Other causes may include toxins, chemicals, and viruses. Sometimes the cause is not known. [icdlist.com]
Occlusive strokes Occlusive strokes, those in which a blood vessel supplying a part of the brain is blocked, are divided into four groups: (1) Transient ischemic attacks (TIAs) are the mildest occlusive strokes; symptoms last for minutes or hours. [britannica.com]
But as far as issues from Lupus, I have no other symptoms that would point to CNS Lupus-ie: seizures, strokes, etc. In fact, as far as I've been told and blood work, my Lupus is not even active. Who knows at this point what is causing what. [msworld.org]
Three years after their initial referral, 401 had a diagnosis of MS, 40 had neurological damage thought to derive from vascular problems (e.g stroke), 24 had a diagnosis of migraine with atypical lesions, 14 had a diagnosis of NMO (neuromyelitis optica [mstrust.org.uk]
With autonomic dysreflexia, these blood vessels intermittently remain constricted, thus elevating the blood pressure and possibly leading to life-threatening complications such as stroke. [my-ms.org]
Workup
Diagnostic workup: History and physical examination MRI brain and spinal cord MRI of the optic nerves Visual and Auditory evoked potentials Somatosensory evoked potentials Lumbar puncture for CSF analysis Treatment: Disease modifying therapy: These therapy [pnpspecialists.com]
"Better explanations" in multiple sclerosis diagnostic workup: A 3-year longitudinal study. Neurology. 2019 May 1. Full article Nerve cells (neurons) Nerve cells, or neurons, make up your nervous system. [mstrust.org.uk]
Therefore, a broad workup including infectious, immunologic, and metabolic tests, as well as a systematic follow-up Magnetic Resonance Imaging (MRI) is needed to establish an accurate diagnosis[5]. [sickkids.ca]
This approach results in increased operator time but should be recommended in the initial workup of patients who are presenting for the first time with neurologic syndromes that suggest a demyelinating disease when sensitivity in detection of brain lesions [ajnr.org]
Treatment
This book will be of interest to students, medical professionals, and others interested in understanding the pathology and treatment of spinal degenerative disease. [books.google.com]
The last MRI, performed after the plasmapheresis treatment, documented progression of the spinal demyelination process. However, the patient became febrile. Immunosuppressive treatment was interrupted for a while. [nature.com]
Treatment The treatment of demyelination depends on the condition. Treatment is focused on management of symptoms and preventing further demyelination. [verywellhealth.com]
Prognosis
Lumbar puncture may be helpful in establishing the diagnosis, as oligoclonal bands are found in more than 80% of patients. 4 Prognosis is directly related to the MS subtype: primary progressive, progressive relapsing, relapsing remitting, and secondary [jaocr.org]
Prognosis 94% recover 20/40 or better at 5 years out in the ONTT. 20/200 or worse visual outcome occurred in 3% of patients at 5 years out in the ONTT. [eyewiki.aao.org]
Compared with patients who had MS, patients who had DNMO had a poor prognosis, higher age at onset, and a more sever clinical course. DNMO was most like to affect female patients. Corticosteroids are not helpful in DNMO, and the prognosis is poor. [radiologykey.com]
Clinicopathologic findings and prognosis of chronic inflammatory demyelinating polyneuropathy. Neurology. 1999;52:498-503. Lewis RA. Multifocal motor neuropathy and Lewis Sumner syndrome: two distinct entities. Muscle Nerve. 1999;22:1738-39. Nevo Y. [rarediseases.org]
Etiology
This disorder is of a heterogeneous pathology, with many different etiologies, including infections, inflammatory, malignant, and metabolic, but a substantial amount of cases remain idiopathic. [sickkids.ca]
However, transverse myelitis encompasses multiple diverse etiologies. Acute idiopathic transverse myelitis is a diagnosis of exclusion once viral and autoimmune causative factors are eliminated. [jaocr.org]
In patients with non-MS phenotypes who are negative for the known autoantibodies, other inflammatory (e.g systemic inflammation) or non-inflammatory (e.g inherited white matter disorders) etiologies should be considered. [frontiersin.org]
This brief guide will help the general ophthalmologist to understand: Optic neuritis is a clinical diagnosis, thus MRI of the orbit with gadolinium looking for optic nerve enhancement, blood testing for inflammatory or infectious etiologies, and lumbar [eyewiki.aao.org]
An infectious etiology has been suggested by the following evidence: The distribution of MS is very non-uniform. Temperate climates have a higher incidence than warm climates, but the disease is uncommon in Japan. [dartmouth.edu]
Epidemiology
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Pathogenesis and epidemiology of multiple sclerosis. https://www.uptodate.com/home. Accessed June 9, 2017. See more Expert Answers . [mayoclinic.org]
In this Research Topic, we welcome original research, review papers, case reports and viewpoint pieces concerning the epidemiology of atypical demyelinating diseases. [frontiersin.org]
Context Epidemiological and experimental evidence suggests that high levels of vitamin D, a potent immunomodulator, may decrease the risk of multiple sclerosis. There are no prospective studies addressing this hypothesis. [tilltrip.phagy.com]
(Epidemiology)", "What Causes MS" PubMed Health: "Myelin Sheath" UpToDate: "Clinical Course and Classification of Multiple Sclerosis.", "Diagnosis of Multiple Sclerosis in Adults", "Treatment of Progressive Multiple Sclerosis in Adults." © 2005-2019 WebMD [onhealth.com]
Pathophysiology
The study will also continue to provide basic information on the biophysical organization of myelinated axon, and on the more general phenomenon of demyelination pathophysiology in the mammalian nervous system. [grantome.com]
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In conclusion, metrics variation in MS patients, especially ihMTratio, suggest important demyelination in normal-appearing WM, consistent with MS pathophysiology. [onlinelibrary.ectrims-congress.eu]
Some likely mechanisms for the pathophysiological damage are as follows. [dovepress.com]
Prevention
Research underway // Treatment can manage symptoms, but there isn’t much we can do yet to prevent demyelination from happening. [health.clevelandclinic.org]
There are a number of treatments used to prevent demyelination. Immunosuppression Preventing the inflammatory process is central to the treatment of many demyelinating conditions, such as MS, ADEM, and GBS. [verywellhealth.com]
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James Sejvar of the US Centers for Disease Control and Prevention who was not involved in the study told The Washington Post. [the-scientist.com]
Caregivers may help move your limbs when you can’t to prevent clots. Later, you’ll get physical therapy to help you use your limbs again. HTLV-I Associated Myelopathy (HAM) This condition results from a virus called HTLV-1. [webmd.com]