SMS variants include stiff-limb syndrome, progressive encephalomyelitis with rigidity and myoclonus (PERM), and a paraneoplastic process associated with breast cancer. Idiopathic gait ataxias sometimes accompany SMS. There is one instance…
The astute neurologist confronted with an unusual, seemingly idiopathic clinical disorder, always needs to be vigilant, asking whether a difficult diagnostic problem could also have a neuroimmunologic basis and eventual…
ADEM results from an autoimmune attack triggered by infection or immunization against CNS myelin proteins. Thus ADEM closely resembles experimental allergic encephalomyelitis (EAE) induced in rodents by CNS myelin products….
Recurrent spinal cord and/or optic nerve inflammation reminiscent of relapsing-remitting MS occurs in 80% of NMO patients. A monophasic course appears in 20%; visual and motor involvement is severe initially….
INTERFERON-β Three interferon-β (IFN-β) formulations are approved for relapsing-remitting MS (RRMS). These are IFN-β-1b (Betaseron) subcutaneously every other day, IFN-β-1a (Rebif) subcutaneously three times weekly and IFN-β-1a (Avonex) intramuscularly weekly….
When the cerebral hemispheres are sectioned, the demyelinating lesions become obvious. These may be numerous or scanty and rounded (as illustrated), oval, or irregular. Recently acquired lesions are soft and…
Careful examination of normal-appearing white matter in progressive MS reveals elongated paranodes with a disrupted profile, axonal swellings, and amyloid precursor protein accumulations. These correlate with the density of ramified…
STEP THREE Perivascular cuff monocytes function as APCs. They capture local antigenic material, process it, and present processed antigen in the context of surface-expressed MHC class II molecules so as…
Clinical Features of an MS Relapse: Events during the clinically apparent phase of a relapse, as with its prelude, involve a series of steps. STEP SIX Conduction Block. The symptoms…
STEP EIGHT The Ending of the Relapse. MS relapses have a finite duration. They are curtailed by a classic feedback loop in which the end product eliminates the originator. Most…
