September 27 Highlights

Abstract

The AAN article by Chaturvedi et al. updates the evidence for indications for carotid endarterectomy. Carotid endarterectomy is recommended for recently symptomatic patients with severe (70 to 99%) internal carotid stenosis. For moderate (50 to 69%), symptomatic stenosis, additional clinical and angiographic factors enter the decisions. see page 794 Sandberg-Wollheim et al. review data on the outcome of 69 pregnancies in relation to IFN beta-1a therapy; 41 occurred in those exposed to IFN during pregnancy. Of the 31 in utero exposures that were not terminated electively, 21 produced healthy infants. The rate of pregnancy loss (9/31) was not significantly different from general population estimates. see page 802 In a prospective controlled study of pregnant women with MS, Boskovic et al. found evidence suggesting that discontinuation of IFN beta increases the risk of pregnancy loss. These results are concordant with data in primates, suggesting that current recommendations to discontinue IFN beta prior to and during pregnancy are appropriate. see page 807 In the editorial on these two articles, Waubant and Sadovnick recommend discontinuing disease modifying therapies for MS prior to initiating pregnancy, but find no …