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Multiple Sclerosis HELP
Based on 19,294 articles since 2006
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These are the 19294 published articles about Multiple Sclerosis that originated from Worldwide during 2006-2015.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis--establishing disease prognosis and monitoring patients. 2015

Wattjes, Mike P / Rovira, Àlex / Miller, David / Yousry, Tarek A / Sormani, Maria P / de Stefano, Maria P / Tintoré, Mar / Auger, Cristina / Tur, Carmen / Filippi, Massimo / Rocca, Maria A / Fazekas, Franz / Kappos, Ludwig / Polman, Chris / Frederik Barkhof, ? / Xavier Montalban, ? / Anonymous940986. · ·Nat Rev Neurol · Pubmed #26369511.

ABSTRACT: The role of MRI in the assessment of multiple sclerosis (MS) goes far beyond the diagnostic process. MRI techniques can be used as regular monitoring to help stage patients with MS and measure disease progression. MRI can also be used to measure lesion burden, thus providing useful information for the prediction of long-term disability. With the introduction of a new generation of immunomodulatory and/or immunosuppressive drugs for the treatment of MS, MRI also makes an important contribution to the monitoring of treatment, and can be used to determine baseline tissue damage and detect subsequent repair. This use of MRI can help predict treatment response and assess the efficacy and safety of new therapies. In the second part of the MAGNIMS (Magnetic Resonance Imaging in MS) network's guidelines on the use of MRI in MS, we focus on the implementation of this technique in prognostic and monitoring tasks. We present recommendations on how and when to use MRI for disease monitoring, and discuss some promising MRI approaches that may be introduced into clinical practice in the near future.

2 Guideline [Update on Current Care Guideline: Multiple sclerosis]. 2015

Remes, Anne / Airas, Laura / Atula, Sari / Färkkilä, Markus / Hartikainen, Päivi / Koivisto, Keijo / Mäenpää, Eliisa / Ruutiainen, Juhani / Sumelahti, Marja-Liisa / Anonymous2090811. · ·Duodecim · Pubmed #26237913.

ABSTRACT: Treatment for relapsing-remitting multiple sclerosis (RRMS) is initiated upon fulfillment of new McDonald 2010 criteria for RRMS. In addition, lumbar puncture is an essential diagnostic method. Interferon-β, dimethyl fumarate, glatiramer acetate and teriflunomide are the first-line immunomodulating drugs (IMD) for RRMS. If the disease is active according to clinical or MRI evaluation during the first-line IMD treatment, alemtuzumab, fingolimod or natalizumab may be considered as second-line therapies. IMD treatment is discontinued upon the transition of RRMS to secondary progressive phase. Rehabilitation should be considered at every phase of the disease.

3 Guideline Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis-clinical implementation in the diagnostic process. 2015

Rovira, Àlex / Wattjes, Mike P / Tintoré, Mar / Tur, Carmen / Yousry, Tarek A / Sormani, Maria P / De Stefano, Nicola / Filippi, Massimo / Auger, Cristina / Rocca, Maria A / Barkhof, Frederik / Fazekas, Franz / Kappos, Ludwig / Polman, Chris / Miller, David / Montalban, Xavier / Anonymous830986. ·Magnetic Resonance Unit, Cemcat, Hospital Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. · MS Centre Amsterdam, VU University Medical Centre, Netherlands. · Neurology/Neuroimmunology Unit, Cemcat, Hospital Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. · Lysholm Department of Neuroradiology, UCLH National Hospital for Neurology and Neurosurgery, University College London Institute of Neurology, UK. · Biostatistics Unit, Department of Health Sciences, University of Genoa, Italy. · Department of Neurological and Behavioural Sciences, University of Siena, Italy. · Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy. · Department of Neurology, Medical University of Graz, Austria. · Department of Neurology, University of Basel, Switzerland. · NMR Research Unit, Queen Square MS Centre, University College London Institute of Neurology, UK. · ·Nat Rev Neurol · Pubmed #26149978.

ABSTRACT: The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal experience of the members of the MAGNIMS (Magnetic Resonance Imaging in MS) network. We address the indications, timing, coverage, reporting and interpretation of MRI studies in patients with suspected MS. Our recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.

4 Guideline Multiple sclerosis: summary of NICE guidance. 2014

Perry, Mark / Swain, Sharon / Kemmis-Betty, Sophia / Cooper, Paul / Anonymous4830793. ·National Clinical Guideline Centre, Royal College of Physicians, London NW1 4LE, UK mark.perry@rcplondon.ac.uk. · National Clinical Guideline Centre, Royal College of Physicians, London NW1 4LE, UK. · Neurology Department, Salford Royal Foundation Trust, Salford, UK Department of Medicine, University of Manchester, Manchester, UK. · ·BMJ · Pubmed #25298369.

ABSTRACT: -- No abstract --

5 Guideline Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 3 treatment practicalities and recommendations. MS Neurology Group of the Australian and New Zealand Association of Neurologists. 2014

Broadley, Simon A / Barnett, Michael H / Boggild, Mike / Brew, Bruce J / Butzkueven, Helmut / Heard, Robert / Hodgkinson, Suzanne / Kermode, Allan G / Lechner-Scott, Jeannette / Macdonell, Richard A L / Marriott, Mark / Mason, Deborah F / Parratt, John / Reddel, Stephen W / Shaw, Cameron P / Slee, Mark / Spies, Judith / Taylor, Bruce V / Carroll, William M / Kilpatrick, Trevor J / King, John / McCombe, Pamela A / Pollard, John D / Willoughby, Ernest / Anonymous2920797. ·School of Medicine, Griffith University, Gold Coast Campus, QLD 4222, Australia; Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia. Electronic address: simon.broadley@griffith.edu.au. · Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia. · Department of Neurology, The Townsville Hospital, Douglas, QLD, Australia. · Department of Neurology and St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia. · Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Eastern Health and Monash University, 2/5 Arnold Street, Box Hill VIC 3128, Australia. · Westmead Clinical School, University of Sydney, NSW, Australia. · South Western Sydney Clinical School, University of New South Wales, NSW, Australia. · Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia. · Hunter Medical Research Institute, The University of Newcastle, New Lambton, NSW, Australia. · Department of Neurology, Austin Health, Heidelberg, VIC, Australia. · Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia. · Department of Neurology, Christchurch Hospital, Christchurch, New Zealand. · Central Clinical School, University of Sydney, NSW, Australia. · School of Medicine, Deakin University, VIC, Australia. · Flinders Medical Centre, Flinders University, SA, Australia. · Menzies Research Institute, University of Tasmania, TAS, Australia. · Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia. · University of Queensland Centre for Clinical Research, QLD, Australia. · Department of Neurology, Auckland City Hospital, Auckland, New Zealand. · ·J Clin Neurosci · Pubmed #24993136.

ABSTRACT: In this third and final part of our review of multiple sclerosis (MS) treatment we look at the practical day-to-day management issues that are likely to influence individual treatment decisions. Whilst efficacy is clearly of considerable importance, tolerability and the potential for adverse effects often play a significant role in informing individual patient decisions. Here we review the issues surrounding switching between therapies, and the evidence to assist guiding the choice of therapy to change to and when to change. We review the current level of evidence with regards to the management of women in their child-bearing years with regards to recommendations about treatment during pregnancy and whilst breast feeding. We provide a summary of recommended pre- and post-treatment monitoring for the available therapies and review the evidence with regards to the value of testing for antibodies which are known to be neutralising for some therapies. We review the occurrence of adverse events, both the more common and troublesome effects and those that are less common but have potentially much more serious outcomes. Ways of mitigating these risks and managing the more troublesome adverse effects are also reviewed. Finally, we make specific recommendations with regards to the treatment of MS. It is an exciting time in the world of MS neurology and the prospects for further advances in coming years are high.

6 Guideline Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 1 historical and established therapies. MS Neurology Group of the Australian and New Zealand Association of Neurologists. 2014

Broadley, Simon A / Barnett, Michael H / Boggild, Mike / Brew, Bruce J / Butzkueven, Helmut / Heard, Robert / Hodgkinson, Suzanne / Kermode, Allan G / Lechner-Scott, Jeannette / Macdonell, Richard A L / Marriott, Mark / Mason, Deborah F / Parratt, John / Reddel, Stephen W / Shaw, Cameron P / Slee, Mark / Spies, Judith / Taylor, Bruce V / Carroll, William M / Kilpatrick, Trevor J / King, John / McCombe, Pamela A / Pollard, John D / Willoughby, Ernest / Anonymous2910797. ·School of Medicine, Griffith University, Gold Coast Campus, QLD 4222, Australia; Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia. Electronic address: simon.broadley@griffith.edu.au. · Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia. · Department of Neurology, The Townsville Hospital, Douglas, QLD, Australia. · Department of Neurology and St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia. · Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia. · Westmead Clinical School, University of Sydney, NSW, Australia. · South Western Sydney Clinical School, University of New South Wales, NSW, Australia. · Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, WA, Australia. · Hunter Medical Research Institute, The University of Newcastle, New Lambton, NSW, Australia. · Department of Neurology, Austin Health, Heidelberg, VIC, Australia. · Department of Neurology, Christchurch Hospital, Christchurch, New Zealand. · Central Clinical School, University of Sydney, NSW, Australia. · School of Medicine, Deakin University, VIC, Australia. · Centre for Neuroscience and Flinders Medical Centre, Flinders University, SA, Australia. · Menzies Research Institute, University of Tasmania, TAS, Australia. · Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia. · Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia. · University of Queensland Centre for Clinical Research, QLD, Australia. · Department of Neurology, Auckland City Hospital, Auckland, New Zealand. · ·J Clin Neurosci · Pubmed #24993135.

ABSTRACT: Multiple sclerosis (MS) is a potentially life-changing immune mediated disease of the central nervous system. Until recently, treatment has been largely confined to acute treatment of relapses, symptomatic therapies and rehabilitation. Through persistent efforts of dedicated physicians and scientists around the globe for 160 years, a number of therapies that have an impact on the long term outcome of the disease have emerged over the past 20 years. In this three part series we review the practicalities, benefits and potential hazards of each of the currently available and emerging treatment options for MS. We pay particular attention to ways of abrogating the risks of these therapies and provide advice on the most appropriate indications for using individual therapies. In Part 1 we review the history of the development of MS therapies and its connection with the underlying immunobiology of the disease. The established therapies for MS are reviewed in detail and their current availability and indications in Australia and New Zealand are summarised. We examine the evidence to support their use in the treatment of MS.

7 Guideline Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of Neurologists. 2014

Broadley, Simon A / Barnett, Michael H / Boggild, Mike / Brew, Bruce J / Butzkueven, Helmut / Heard, Robert / Hodgkinson, Suzanne / Kermode, Allan G / Lechner-Scott, Jeannette / Macdonell, Richard A L / Marriott, Mark / Mason, Deborah F / Parratt, John / Reddel, Stephen W / Shaw, Cameron P / Slee, Mark / Spies, Judith / Taylor, Bruce V / Carroll, William M / Kilpatrick, Trevor J / King, John / McCombe, Pamela A / Pollard, John D / Willoughby, Ernest / Anonymous2900797. ·School of Medicine, Griffith University, Gold Coast Campus, QLD 4222, Australia; Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia. Electronic address: simon.broadley@griffith.edu.au. · Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia. · Department of Neurology, The Townsville Hospital, Douglas, QLD, Australia. · Department of Neurology and St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia. · Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Eastern Health and Monash University, 2/5 Arnold Street, Box Hill VIC 3128, Australia. · Westmead Clinical School, University of Sydney, NSW, Australia. · South Western Sydney Clinical School, University of New South Wales, NSW, Australia. · Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, WA, Australia. · Hunter Medical Research Institute, The University of Newcastle, New Lambton, NSW, Australia. · Department of Neurology, Austin Health, Heidelberg, VIC, Australia. · Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia. · Department of Neurology, Christchurch Hospital, Christchurch, New Zealand. · Central Clinical School, University of Sydney, NSW, Australia. · School of Medicine, Deakin University, VIC, Australia. · Flinders Medical Centre, Flinders University, SA, Australia. · Menzies Research Institute, University of Tasmania, TAS, Australia. · Centre for Neuromuscular and Neurological Disorders, University of Western Australia, WA, Australia. · Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia. · University of Queensland Centre for Clinical Research, QLD, Australia. · Department of Neurology, Auckland City Hospital, Auckland, New Zealand. · ·J Clin Neurosci · Pubmed #24986155.

ABSTRACT: In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs. We go on to compare the relative efficacies of these newer and emerging therapies alongside the existing therapies. The effectiveness of β-interferon in the treatment of different stages and the different disease courses of MS is critically reviewed with the conclusion that the absolute level of response in term of annualised relapse rates (where relapses occur) and MRI activity are similar, but are disappointing in terms of sustained disability progression for progressive forms of the disease. Finally we review the controversial area of combination therapy for MS. Whilst it remains the case that we have no cure or means of preventing MS, we do have a range of effective therapies that when used appropriately and early in the disease course can have a significant impact on short term and longer term outcomes.

8 Guideline Guidelines on the clinical use for the detection of neutralizing antibodies (NAbs) to IFN beta in multiple sclerosis therapy: report from the Italian Multiple Sclerosis Study group. 2014

Bertolotto, Antonio / Capobianco, Marco / Amato, Maria Pia / Capello, Elisabetta / Capra, Ruggero / Centonze, Diego / Di Ioia, Maria / Gallo, Antonio / Grimaldi, Luigi / Imberti, Luisa / Lugaresi, Alessandra / Mancinelli, Chiara / Marrosu, Maria Giovanna / Moiola, Lucia / Montanari, Enrico / Romano, Silvia / Musu, Luigina / Paolicelli, Damiano / Patti, Francesco / Pozzilli, Carlo / Rossi, Silvia / Salvetti, Marco / Tedeschi, Gioachino / Tola, Maria Rosaria / Trojano, Maria / Zaffaroni, Mauro / Malucchi, Simona / Anonymous3600772. ·Neurologia 2-CRESM, AOU San Luigi, Orbassano, Italy. · ·Neurol Sci · Pubmed #24374787.

ABSTRACT: Interferon beta (IFNβ) was the first specific disease-modifying treatment licensed for relapsing-remitting multiple sclerosis, and is still one of the most commonly prescribed treatments. A strong body of evidence supports the effectiveness of IFNβ preparations in reducing the annual relapse rate, magnetic resonance (MRI) disease activity and disease progression. However, the development of binding/neutralizing antibodies (BAbs/NAbs) during treatment negatively affects clinical and MRI outcomes. Therefore, guidelines for the clinical use for the detection of NAbs in MS may result in better treatment of these patients. In October 2012, a panel of Italian neurologists from 17 MS clinics convened in Milan to review and discuss data on NAbs and their clinical relevance in the treatment of MS. In this paper, we report the panel's recommendations for the use of IFNβ Nabs detection in the early identification of IFNβ non-responsiveness and the management of patients on IFNβ treatment in Italy, according to a model of therapeutically appropriate care.

9 Guideline Guideline for the diagnosis and management of multiple sclerosis: a Southern African perspective. 2013

Giampaolo, D / Bhigjee, A / Retief, C / Isaacs, M / Britz, M / Opperman, D / Govender, R / van Rensburg, M / Anonymous3830765. ·Netcare Rosebank Hospital, Johannesburg, South Africa. docman1@me.com. · ·S Afr Med J · Pubmed #24300689.

ABSTRACT: Before making a diagnosis of multiple sclerosis (MS), it is imperative that alternative diagnoses are considered and excluded. This is particularly important in South Africa, which is a moderate prevalence MS area, has a high burden of neurological infections and where the majority of the people are black - an ethnic group that has a very low frequency of MS. Before applying diagnostic criteria, there should be no better explanation for the patient's presentation. This guideline, written on behalf of the Multiple Sclerosis Society of South Africa, aims to assist in the diagnosis and treatment of MS in Southern Africa. 

10 Guideline [Consensus document on spasticity in patients with multiple sclerosis. Grupo de Enfermedades Desmielinizantes de la Sociedad Española de Neurología]. 2013

Oreja-Guevara, Celia / Montalban, Xavier / de Andrés, Clara / Casanova-Estruch, Bonaventura / Muñoz-García, Delicias / García, Inmaculada / Fernández, Óscar / Anonymous1080760. ·Hospital Clinico San Carlos, 28040 Madrid, Espana. · ·Rev Neurol · Pubmed #24081891.

ABSTRACT: INTRODUCTION: Multiple sclerosis is a chronic neurological inflammatory demyelinating disease. Specialists involved in the symptomatic treatment of this disease tend to apply heterogeneous diagnostic and treatment criteria. AIM: To establish homogeneous criteria for treating spasticity based on available scientific knowledge, facilitating decision-making in regular clinical practice. DEVELOPMENT: A group of multiple sclerosis specialists from the Spanish Neurological Society demyelinating diseases working group met to review aspects related to spasticity in this disease and draw up the consensus. After an exhaustive bibliographic search and following a metaplan technique, a number of preliminary recommendations were established to incorporate into the document. Finally, each argument was classified depending on the degree of recommendation according to the SIGN (Scottish Intercollegiate Guidelines Network) system. The resulting text was submitted for review by the demyelinating disease group. An experts' consensus was reached regarding spasticity triggering factors, related symptoms, diagnostic criteria, assessment methods, quality of life and therapeutic management (drug and non-drug) criteria. CONCLUSION: The recommendations included in this consensus can be a useful tool for improving the quality of life of multiple sclerosis patients, as they enable improved diagnosis and treatment of spasticity.

11 Guideline Guidelines from The Italian Neurological and Neuroradiological Societies for the use of magnetic resonance imaging in daily life clinical practice of multiple sclerosis patients. 2013

Filippi, Massimo / Rocca, Maria A / Bastianello, Stefano / Comi, Giancarlo / Gallo, Paolo / Gallucci, Massimo / Ghezzi, Angelo / Marrosu, Maria Giovanna / Minonzio, Giorgio / Pantano, Patrizia / Pozzilli, Carlo / Tedeschi, Gioacchino / Trojano, Maria / Falini, Andrea / De Stefano, Nicola / Anonymous5390764 / Anonymous5400764. ·Neuroimaging Research Unit, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, m.filippi@hsr.it. · ·Neurol Sci · Pubmed #23828372.

ABSTRACT: MRI is highly sensitive in detecting focal white matter lesions in multiple sclerosis (MS). For this reason, it has been formally included in the diagnostic workup of patients with clinically isolated syndromes suggestive of MS, through the definition of ad hoc sets of criteria to show disease dissemination in space and time. MRI is used in virtually all clinical trials of the disease as a surrogate measure of treatment response. Several guidelines have been published to help characterizing the imaging features on conventional MR sequences of "typical" MS lesions and work has also been performed to identify "red flags" which should alert the clinicians to exclude possible alternative conditions. Despite this, the application of the available guidelines and criteria in daily life clinical practice is still limited and varies among and within countries (including Italy) due to regulatory issues and heterogeneity of MRI facilities. It is crucial for neurologists and neuroradiologists to become familiar with these criteria to improve the quality of their diagnostic assessment. In patients with established MS, the main problem is to define standard procedures for monitoring the course of the disease and treatment response. This review aims at providing daily life guidelines to clinicians for a correct application of MRI in the workup of patients suspected of having MS as well as in the monitoring of disease evolution in those with established MS. It also offers clues for the standardization of MRI studies and relative reporting to be applied at a national level.

12 Guideline Consensus Statement on medication use in multiple sclerosis by the Spanish Society of Neurology's study group for demyelinating diseases. 2013

García-Merino, A / Fernández, O / Montalbán, X / de Andrés, C / Oreja-Guevara, C / Rodríguez-Antigüedad, A / Arbizu, T / Anonymous3840753. ·Servicio de Neurología/Unidad de Neuroinmunología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España. jgarciam.hpth@salud.madrid.org · ·Neurologia · Pubmed #23643683.

ABSTRACT: Treatments for multiple sclerosis therapy are rapidly evolving. It is believed that new drugs will be approved in the near future, thereby changing current indications for treatment. In this context, the Spanish Society of Neurology's study group on demyelinating diseases, which evaluates medication use in MS, has decided to draw up a consensus statement on the current indications and guidelines for multiple sclerosis treatment.

13 Guideline International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. 2013

Krupp, Lauren B / Tardieu, Marc / Amato, Maria Pia / Banwell, Brenda / Chitnis, Tanuja / Dale, Russell C / Ghezzi, Angelo / Hintzen, Rogier / Kornberg, Andrew / Pohl, Daniela / Rostasy, Kevin / Tenembaum, Silvia / Wassmer, Evangeline / Anonymous3730757. ·Lourie Center for Pediatric MS. Stony Brook University Medical Center, USA. lauren.krupp@stonybrook.edu · ·Mult Scler · Pubmed #23572237.

ABSTRACT: BACKGROUND: There has been tremendous growth in research in pediatric multiple sclerosis (MS) and immune mediated central nervous system demyelinating disorders since operational definitions for these conditions were first proposed in 2007. Further, the International Pediatric Multiple Sclerosis Study Group (IPMSSG), which proposed the criteria, has expanded substantially in membership and in its international scope. OBJECTIVE: The purpose of this review is to revise the 2007 definitions in order to incorporate advances in delineating the clinical and neuroradiologic features of these disorders. METHODS: Through a consensus process, in which input was sought from the 150 members of the Study Group, criteria were drafted, revised and finalized. Final approval was sought through a web survey. RESULTS: Revised criteria are proposed for pediatric acute disseminated encephalomyelitis, pediatric clinically isolated syndrome, pediatric neuromyelitis optica and pediatric MS. These criteria were approved by 93% or more of the 56 Study Group members who responded to the final survey. CONCLUSIONS: These definitions are proposed for clinical and research purposes. Their utility will depend on the outcomes of their application in prospective research.

14 Guideline Consensus guidelines for the diagnosis and treatment of multiple sclerosis. 2013

Yamout, B / Alroughani, R / Al-Jumah, M / Khoury, S / Abouzeid, N / Dahdaleh, M / Alsharoqi, I / Inshasi, J / Hashem, S / Zakaria, M / ElKallab, K / Alsaadi, T / Tawfeek, T / Bohlega, S. ·American University of Beirut Medical Center, Beirut, Lebanon. yamoutba@gmail.com · ·Curr Med Res Opin · Pubmed #23514115.

ABSTRACT: The diagnosis of multiple sclerosis (MS) is dependent on the presence of clinical and paraclinical evidence demonstrating dissemination of central nervous system lesions in both space and time, as well as the exclusion of other disorders. Diagnostic criteria were originally promulgated in 1965 by the Schumacher committee and modified subsequently by the Poser committee to include paraclinical evidence. The most recent criteria are the 2010 modifications of the 2001 McDonald criteria, which are focused on making an earlier diagnosis of MS. This article provides guidelines, derived from clinical experience as well as evidence-based medicine, for the diagnosis and management of MS with special emphasis on practices in the Middle East.

15 Guideline LSN MS guidelines for the management of multiple sclerosis. 2013

Shatila, A R / Koussa, S / Jabbour, R / Mourad, A / Aouad, A / Sabbagh, G / Kallab, K / Hilal, R / Khalifeh, R / Gebeily, S / Tourbah, A / Anonymous180766. ·Neurology Division Makassed Hospital, Ouzai Street Tarik Al-Jadida, Beirut, Lebanon. · ·Rev Neurol (Paris) · Pubmed #23434141.

ABSTRACT: OBJECTIVE: The prevalence of multiple sclerosis (MS) in Lebanon is unknown, as there are no available or reliable epidemiological studies to date. The circumstances of Middle East countries are different from those of Europe and North America in terms of differential diagnoses and disease management. The aim of the conference is to establish guidelines for diagnosis, treatment, follow-up and management of patients with MS in Lebanon. Another objective is to discuss and participate in research projects based on epidemiology, clinical trials and more fundamental aspects of the disease in the future. METHODS: Under the authority of the Lebanese Society of Neurology (LSN), a group of neurologists took the initiative to participate in this LSN MS committee with the purpose of establishing a consensus for the management of patients with MS, and under the supervision of a Coordinator (A.T.) designed by the LSN board. RESULTS: Diagnostic and therapeutic, follow-up and research recommendations were proposed with special emphasis on the specific needs and circumstances of Lebanon. The experts highlighted the importance of considering particular needs, the identification of patients at high risk of developing MS in order to maximize therapeutic opportunities, and cost-effective control of treatment efficacy, as well as global assessment of disability. CONCLUSIONS: The experts established guidelines concerning diagnosis, treatment, and follow-up of patients with MS in Lebanon. Furthermore, they recommended some clinical and fundamental research projects.

16 Guideline Recommendations for useful serum testing with suspected multiple sclerosis. 2013

Ouallet, J-C / Bodiguel, E / Bensa, C / Blanc, F / Brassat, D / Laplaud, D / Zephir, H / de Seze, J / Magy, L / Anonymous3400740. ·Inserm U 1049, pôle des neurosciences cliniques, service de neurologie, CHU de Bordeaux Pellegrin Tripode, université de Bordeaux Segalen, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. jean-christophe.ouallet@chu-bordeaux.fr · ·Rev Neurol (Paris) · Pubmed #22325711.

ABSTRACT: Several practical questions useful for management of patients with multiple sclerosis remain unanswered in the current scientific literature. Decisions are often made individually, without the support of solid scientific evidence. In order to facilitate concurring practices, we present guidelines concerning useful serum exams for the diagnosis of multiple sclerosis. The methodology used was that of a formal expert consensus. A working group performed a systematic analysis of the literature, taking into account both previously existing recommendations and original articles, and then drafted guideline proposals. These proposals were subjected to the critical review of a rating group. Three written drafts, followed by rating of the guideline proposals culminated in a consensual document, which was submitted for review to a second independent reading group. The final resulting document provided the material for the present article, in which each recommendation is presented with its grade according to the level of proof or its degree of consensus in the absence of scientific proof.

17 Guideline [LACTRIMS consensus document for the pharmacological treatment of the multiple sclerosis and its clinical variants]. 2012

Abad, P / Nogales-Gaete, J / Rivera, V / Cristiano, E / Hamuy, F / Oehninger, C / Alvarenga, R M P / Tenembaum, S / Anonymous1370734. ·Hospital Metropolitano, Quito, Ecuador. · ·Rev Neurol · Pubmed #23233142.

ABSTRACT: INTRODUCTION. Multiple sclerosis (MS) it is not considered any more a rare disease in Latin America. Most of the Latin American countries have reported moderate or lower prevalence data. However only very few countries have developed therapeutic guidelines. LACTRIMS prepared this consensus document with specific recommendations for the treatment of the disease. DEVELOPMENT. Experts on treatment and clinical research on MS were invited by LACTRIMS in order to generate a initial document to be discussed in Quito, Ecuador. Several groups were organized in relation of the different clinical variants. These groups were coordinated by experts leaders and prepared a preliminary document that was discussed in Quito during July 8th and 9th, 2011. Finally the final version was submitted to the members and delegates of LACTRIMS in most of the Latin American countries who were able to make modifications and suggest changes to the final manuscript. CONCLUSIONS. Based on the different evidence levels and the AGREE criteria, the clinical variants were reviewed and recommendations were made for the use of drugs and different modifying disease therapeutic agents.

18 Guideline Recommendations for diagnosis and management of multiple sclerosis. 2012

Kes, Vanja Basić / Zavoreo, Iris / Serić, Vesna / Solter, Vesna Vargek / Cesarik, Marijan / Hajnsek, Sanja / Pasić, Marija Bosnjak / Gabelić, Tereza / Silvio, Basić / Butković, Silva Soldo / Lusić, Ivo / Grbelja, Lidija Dezmalj / Vladić, Ante / Bielen, Ivan / Antoncić, Igor / Demarin, Vida / Anonymous3090725 / Anonymous3100725 / Anonymous3110725. ·University Department of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia. vanjakes@net.hr · ·Acta Clin Croat · Pubmed #22920014.

ABSTRACT: Multiple sclerosis (MS) is a chronic demyelinating neurologic disorder that mainly affects young individuals (aged 20 to 50 years). Approximately 85% of patients experience an initial course with relapses and remissions (relapsing-remitting multiple sclerosis). Guidelines for the management of MS should be focused on three main areas: (a) the diagnosis of MS; (b) treatment of relapses; and (c) long-term preventive treatment including clinical follow up, dose adjustment, drug switch, control of therapeutic efficacy, and disease progression. Diagnosis should be established according to clinical and paraclinical criteria. Discussion on therapeutic recommendations is focused on the disease-modifying agents in acute phases and drugs for long-term treatment and symptomatic treatment. Differential diagnoses must be taken into account on making the diagnosis of MS. Therefore, diagnosis of MS should be established on clinical and radiological diagnostic criteria, cerebrospinal fluid analysis and evoked potentials.

19 Guideline Recommendations for the detection and therapeutic management of cognitive impairment in multiple sclerosis. 2012

Bensa, C / Bodiguel, E / Brassat, D / Laplaud, D / Magy, L / Ouallet, J-C / Zephir, H / De Seze, J / Blanc, F / Anonymous1300732. ·Fondation Rothschild, service de neurologie, 25-29 rue Manin, Paris, France. carobensa@hotmail.com · ·Rev Neurol (Paris) · Pubmed #22658753.

ABSTRACT: The aim of the Multiple Sclerosis Think Tank (Groupe de réflexion sur la sclérose en plaques [GRESEP]) is to prescribe recommendations following a systematic literature search and using a Rand Corporation and California University (RAND/UCLA) appropriateness derived method, in response to practical questions that are raised in the management of patients with multiple sclerosis (MS). The topics of this working program were chosen because they were not addressed in the French recommendations and because of the few data in the literature that enabled practices to be based on validated data. Following the theme on useful serum testing with suspected multiple sclerosis, the subjects of the present work concern the detection and management of cognitive impairment in the beginning stages of the disease course. Two clinical questions were asked: which complementary exams (besides physical examination and neuropsychological tests) would help in the screening of cognitive impairment at the beginning of the disease? What care management should the person with MS and cognitive impairment be offered (treatments and neurocognitive rehabilitation)? The recommendations are the result of a consensus amongst a working group, a rating group and a reading group comprised of hospital neurologists involved in the management of patients with multiple sclerosis. Each recommendation is presented with the degree of consensus that it was accorded.

20 Guideline Recommendations for the management of multiple sclerosis relapses. 2012

Laplaud, D / Bodiguel, E / Bensa, C / Blanc, F / Brassat, D / Magy, L / Ouallet, J-C / Zephir, H / De Seze, J / Anonymous5730717. ·INSERM UMR643, service de neurologie, clinique neurologique, faculté de médecine de Nantes, CHU de Nantes, place A.-Ricordeau, Nantes cedex, France. david.laplaud@univ-nantes.fr · ·Rev Neurol (Paris) · Pubmed #22555010.

ABSTRACT: The aim of the Multiple Sclerosis Think Tank (Groupe de Réflexion sur la Sclérose en Plaques [GRESEP]), composed of hospital neurologists involved in the management of patients with multiple sclerosis, is to provide recommendations in response to clinical questions that are raised when managing these patients. After work done on the themes of useful serum testing with suspected multiple sclerosis, detection and management of cognitive disorders early in the course of the disease, and definition and early management of the disease, GRESEP wanted to develop recommendations on the management of multiple sclerosis (MS) relapse. Following a systematic analysis of the literature, the procedure of formal expert consensus enabled consensual recommendations among a working group, a rating group and a reading group to be written. Each recommendation is presented with its grade or the degree of consensus that it was accorded.

21 Guideline Recommendations for a definition of multiple sclerosis in support of early treatment. 2012

Zéphir, H / Bodiguel, E / Bensa, C / Blanc, F / Laplaud, D / Magy, L / Ouallet, J-C / De Seze, J / Brassat, D / Anonymous4050715. ·Pôle de neurologie, université Lille Nord de France, hôpital Roger-Salengro, CHRU de Lille, 1, rue du Professeur-Émile-Laine, 59037 Lille, France. helene.zephir@chru-lille.fr · ·Rev Neurol (Paris) · Pubmed #22398217.

ABSTRACT: The aim of the Multiple Sclerosis Think Tank (Groupe de Réflexion sur la Sclérose en Plaques: GRESEP), composed of hospital neurologists involved in the management of patients with multiple sclerosis, is to provide recommendations in response to clinical questions that are raised when managing these patients. After work done on the themes on useful serum testing with suspected multiple sclerosis, as well as the detection and management of cognitive disorders early in the course of the disease, the subject of the present work is the early definition and early treatment of the disease. Following a systematic literature review, a RAND/UCLA appropriateness-derived method enabled consensual recommendations among a working group, a rating group and a reading group to be developed and formulated. Each recommendation is presented with the degree of consensus that it was accorded.

22 Guideline The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and select comorbid medical conditions. 2012

Ramasubbu, Rajamannar / Taylor, Valerie H / Samaan, Zainab / Sockalingham, Sanjeev / Li, Madeline / Patten, Scott / Rodin, Gary / Schaffer, Ayal / Beaulieu, Serge / McIntyre, Roger S / Anonymous4370709. ·Department of Psychiatry and Clinical Neurosciences, University of Calgary, Hotchkiss Brain Institute, Calgary, Alberta, Canada. rramasub@ucalgary.ca · ·Ann Clin Psychiatry · Pubmed #22303525.

ABSTRACT: BACKGROUND: Medical comorbidity in patients with mood disorders has become an increasingly important clinical and global public health issue. Several specific medical conditions are associated with an increased risk of mood disorders, and conversely, mood disorders are associated with increased morbidity and mortality in patients with specific medical disorders. METHODS: To help understand the bidirectional relationship and to provide an evidence-based framework to guide the treatment of mood disorders that are comorbid with medical illness, we have reviewed relevant articles and reviews published in English-language databases (to April 2011) on the links between mood disorders and several common medical conditions, evaluating the efficacy and safety of pharmacologic and psychosocial treatments. The medical disorders most commonly encountered in adult populations (ie, cardiovascular disease, cerebrovascular disease, cancer, human immunodeficiency virus, hepatitis C virus, migraine, multiple sclerosis, epilepsy, and osteoporosis) were chosen as the focus of this review. RESULTS: Emerging evidence suggests that depression comorbid with several medical disorders is treatable and failure to treat depression in medically ill patients may have a negative effect on medical outcomes. CONCLUSIONS: This review summarizes the available evidence and provides treatment recommendations for the management of comorbid depression in medically ill patients.

23 Guideline Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). 2012

Langdon, D W / Amato, M P / Boringa, J / Brochet, B / Foley, F / Fredrikson, S / Hämäläinen, P / Hartung, H-P / Krupp, L / Penner, I K / Reder, A T / Benedict, R H B. ·Royal Holloway, University of London, Surrey, UK. d.langdon@rhul.ac.uk · ·Mult Scler · Pubmed #22190573.

ABSTRACT: BACKGROUND: Cognitive impairment in MS impacts negatively on many patients at all disease stages and in all subtypes. Full clinical cognitive assessment is expensive, requiring expert staff and special equipment. Test versions and normative data are not available for all languages and cultures. OBJECTIVE: To recommend a brief cognitive assessment for multiple sclerosis (MS) that is optimized for small centers, with one or few staff members, who may not have neuropsychological training and constructed to maximize international use. METHODS: An expert committee of twelve members representing the main cultural groups that have so far contributed considerable data about MS cognitive dysfunction was convened. Following exhaustive literature review, peer-reviewed articles were selected to cover a broad spectrum of cultures and scales that targeted cognitive domains vulnerable to MS. Each was rated by two committee members and candidates scales were rated on psychometric qualities (reliability, validity, and sensitivity), international application, ease of administration, feasibility in the specified context, and acceptability to patients. RESULTS: The committee recommended the Symbol Digit Modalities Test, if only 5 minutes was available, with the addition of the California Verbal Learning Test - Second Edition and the Brief Visuospatial Memory Test - Revised learning trials if a further 10 minutes could be allocated for testing. CONCLUSIONS: A brief cognitive assessment for MS has been recommended. A validation protocol has been prepared for language groups and validation studies have commenced.

24 Guideline Screening for chronic cerebrospinal venous insufficiency (CCSVI) using ultrasound--recommendations for a protocol. 2011

Zamboni, P / Morovic, S / Menegatti, E / Viselner, G / Nicolaides, A N. ·Vascular Diseases Center, University of Ferrara, Ferrara, Italy. zmp@unife.it · ·Int Angiol · Pubmed #22233619.

ABSTRACT: Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Studies using ultrasound in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 70%; range 0-100%; N.=1496), whereas, in normal controls and patients without MS the prevalence was much lower (mean 10%; range 0-36%; N.=635). Ultrasound uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results. A high prevalence ranging from 62% to 100% of obstructive lesions has been found by some teams in patients with MS compared with a lower prevalence of 0-25% in controls. However, absence of such lesions or a lower prevalence (16-52%) has been reported by others. This variability could be the result of differences in technique, training, experience or criteria used. The current lack of a methodology shared among experts is a confounding element in epidemiologic studies, and does not permit further Bayesan or other kind of analysis. In order to ensure a high reproducibility of Duplex scanning with comparable accuracy between centers, a detailed protocol with standard methodology and criteria is proposed. This is also necessary for training. It has been shown that inter-rater variability increases post-training (from k=0.47 to k=0.80), while within-rater reproducibility in trained operators was k=0.75. Finally, the consensus document proposes a reporting standard of Duplex measurements, and future research to answer areas of uncertainty.

25 Guideline Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. 2011

Scott, T F / Frohman, E M / De Seze, J / Gronseth, G S / Weinshenker, B G / Anonymous6060703. ·Drexel University School of Medicine/Allegheny MS Treatment Center, Pittsburgh, PA, USA. · ·Neurology · Pubmed #22156988.

ABSTRACT: OBJECTIVE: To assess the evidence for diagnostic tests and therapies for transverse myelitis (TM) and make evidence-based recommendations. METHODS: A review of the published literature from 1966 to March 2009 was performed, with evidence-based classification of relevant articles. RECOMMENDATIONS: Level B recommendations: neuromyelitis optica (NMO)-immunoglobulin G (IgG) antibodies should be considered useful to determine TM cause in patients presenting with clinical acute complete transverse myelitis (ACTM) features. The presence of NMO-IgG antibodies (aquaporin-4-specific antibodies) should be considered useful in determining increased TM recurrence risk. Level C recommendations: in suspected TM, distinction between ACTM or acute partial transverse myelitis may be considered useful to determine TM etiology and risk for relapse (more common with APTM). Age and gender may be considered useful to determine etiology in patients presenting with TM syndrome, with spinal infarcts seen more often in older patients and more female than male patients having TM due to multiple sclerosis (MS). Brain MRI characteristics consistent with those of MS may be considered useful to predict conversion to MS after a first partial TM episode. Longer spinal lesions extending over >3 vertebral segments may be considered useful in determining NMO vs MS. CSF examination for cells and oligoclonal bands may be considered useful to determine the cause of the TM syndrome. Plasma exchange may be considered in patients with TM who fail to improve after corticosteroid treatment. Rituximab may be considered in patients with TM due to NMO to decrease the number of relapses. Level U recommendations: there is insufficient evidence to support or refute the efficacy of other TM therapies or the usefulness of ethnicity to determine the cause of a subacute myelopathy.

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