Diagnosis Of Sclerosis Research Articles

Differential diagnosis of acute myelopathies.

Diagnosis of acute myelopathy applies to subjects with acute motor involvement, segmental sensory loss and sphincter dysfunction, reaching a maximum no later than 4 weeks after onset. Among the different causes of acute myelopathy (e.g. compressive, vascular, traumatic or toxic lesions, paraneoplastic involvement and electrical injury), acute myelitis due to infective agents or to an autoimmune-inflammatory process frequently causes problems relating to the differential diagnosis of multiple sclerosis (MS) and its potential risk of developing MS.

Cranial nerve, brainstem and cerebellar syndromes in the differential diagnosis of multiple sclerosis.

A clinically isolated syndrome indicating a pathological process involving the cranial nerves or the posterior fossa may constitute a hard diagnostic challenge for the clinician. Whereas internuclear ophthalmoplegia, for example, is almost pathognomonic of multiple sclerosis (MS), other clinical presentations are often puzzling. The main alternative causes of symptoms that may suggest a clinical onset of MS are reviewed here, grouped in principal clinical syndromes, with particular attention to some rare, recently recognised conditions.

Multiple sclerosis: How practice nurses can help

Megan Burgess explains the pathology and diagnosis of multiple sclerosis, and suggests how practice nurses can help give people diagnosed with MS the special advice and care they need.

Magnetic resonance imaging of MS-like disease.

Early diagnosis of multiple sclerosis (MS) represents, to date, an essential endpoint. Diagnostic certainty may, indeed, mean the possibility to start preventive treatments and delay the appearance of a clinically definitive MS or the progression of the disease. Magnetic resonance imaging (MRI) represent a valid tool for early diagnosis, albeit several neurologic disorders may mimic the MRI findings of MS.

Relationship between histopathological diagnosis of hippocampal sclerosis and pre-surgical measurement of hippocampal volume and T2 relaxation time in patients with intractable temporal lobe epilepsy

Relationship between histopathological diagnosis of hippocampal sclerosis and pre-surgical measurement of hippocampal volume and T2 relaxation time in patients with intractable temporal lobe epilepsy

Utilidad clínica de las bandas oligoclonales

The presence of oligoclonal bands (OCB) of immunoglobulin G (IgG) is in our days the most useful finding in the study of the CSF for the diagnosis of multiple sclerosis (MS). The most sensitive method for the detection of OCB is the isoelectric focusing followed by immunoblotting. The prevalence of OCB changes in different populations with a rank of results from 60 to 95 97%. We have determined the prevalence of OCB in our population and the sensitivity and the specificity of the technique used in our laboratory. We have included 391 patients in whom we analysed the presence of OCB, subdivided in; Group 0: Diagnosed of MS, group 1: First episode of demyelinating process, group 2: Neurological disorders considered noninflammatory or nonautoimmune (NINA),group 3: Neurological disorders considered inflammatory, infectious or autoimmune (IIA). The presence of OCB was searched in CSF and serum simultaneously using isoelectric focusing and immunoblotting. In order to standardize the technique we achieved and internal and external validation. Internal validation: sensitivity and specificity (using as a control group first the group NINA and after the group IA). External validation: we choose 10 pairs of CSF/serum from patients with different diagnostics and sent to a reference laboratory ( Karolinska Institute Medical School) that was blind of our results and of the diagnostics. The prevalence of OCB in each group has been: group 0 (MS): 87.7%, group 1: 54.8%, group 2 (NINA): 17.5%, group 3(IIA): 52.7%. Sensitivity: 97.7%, specificity using group NINA as control 82.5% and using group IIA 45.7%. Concordance with the reference laboratory in 9/10 determinations. We conclude that in our population the prevalence of OCB, in patients with MS, is lower than in Northern Europe. The OCB appear in may inflammatory, autoimmune diseases, their specificity for the diagnostic of MS is low.

EDSS correlated analysis of median nerve somatosensory evoked potentials in multiple sclerosis.

Median nerve somatosensory evoked potentials (SEP) were recorded in 30 patients with multiple sclerosis. The examined patients had an expanded disability status scale (EDSS) between 0 and 6. The primary cortical potential N20, the subcortical potentials P14, N13b, N13a and the peripheral potential P9 were recorded simultaneously. In 5 patients normal SEP were observed (group 1), and in 6 patients there were consecutive disturbances of the somatosensory pathway (group 3). In 19 patients subcortical potentials were abnormal or absent while the following potentials were normal or identified which pattern corresponds to amplification within CNS structures (group 2). The EDSS of groups 1 and 2 were similar and lower than the EDSS of group 3, which indicates that amplification mechanisms could represent a positive prognostic factor in SEP diagnosis of multiple sclerosis.

Serum from patients with multiple sclerosis affects electrical activity in neocortical slices of guinea pigs.

The serum from patients with multiple sclerosis changes electrical activity of neocortical slices of guinea pigs. This test can be used for the diagnosis of multiple sclerosis and assessment of treatment efficiency.

INTRACARDIAC TUMOUR AND BRAIN LESIONS IN TUBEROUS SCLEROSIS. A case report of antenatal diagnosis by ultrasonography

A case of antenatal tuberous sclerosis was diagnosed by ultrasonography. Intracardiac tumour (highly suspected rhabdomyoma) with transitory heart failure and multiple brain lesions were observed. After delivery, echocardiography, spiral CT and MR imaging diagnosis of tuberous sclerosis was confirmed by typical skin lesions (depigmented macules) and development of seizures.

Multiple sclerosis and poliomyelitis. A Danish historical cohort study.

To evaluate whether persons with a history of poliomyelitis are at an increased risk of developing multiple sclerosis (MS). All patients diagnosed with acute poliomyelitis in the greater capital area of Copenhagen, Denmark, between 1919 and 1954 were identified and followed with respect to MS. Information on vital status and diagnosis of sclerosis was obtained through linkage with the Danish Civil Registration System and The Danish Multiple Sclerosis Registry, respectively. Follow-up started on the date of the establishment of the Danish Civil Registration System (April 1, 1968) until death, emigration or December 31, 1996, whichever came first. The observed incidence of MS among polio patients was compared with the expected incidence calculated according to national gender, age and period specific rates of MS. During 149,364 years of follow-up, 19 cases of multiple sclerosis were observed among 5652 polio patients compared with 11.0 expected (SIR = 1.73 (1.04-2.74)). The increased risk of MS was most pronounced in polio patients hospitalized during adolescence. Neither gender nor the acute severity of poliomyelitis modified the risk of MS. Our results are based on small numbers of events, however the findings suggest that the polio patients might be at an increased risk of MS.

Use of MRI Technology in Determining Prognosis and Tracking Therapeutic Benefit in Multiple Sclerosis

Abstract Over the past decade, magnetic resonance imaging (MRI) has been increasingly used as a tool to facilitate the diagnosis of multiple sclerosis (MS). Because of the relative insensitivity of commonly used clinical assessment measures, however, clinicians are exploring ways in which MRI can be used to determine a patient's prognosis and track progression of the disease. This article discusses the MRI findings that may be useful in evaluating disease progression in MS; results of recent clinical trials of MS treatment agents that have employed MRI; and potential applications for MRI in clinical practice.

ALS Mimic Syndromes: A Diagnostic Challenge

A diagnosis of amyotrophic lateral sclerosis (ALS) is devastating, carrying with it the expectation of inexorable decline and death over only a few

Effects of the early diagnosis of amyotrophic lateral sclerosis on the patient: disadvantages.

While the early diagnosis of disease is generally desirable, this is not always so. There is reason to be concerned about the reliability of clinical diagnosis of amyotrophic lateral sclerosis (ALS), based on currently available methods, early in the disease process. Applying the standard of cost-effectiveness it is possible to estimate the effort required to extend the lifespan of persons who are detected through a screening programme. Until it is possible to alter the treatment outcome, patients have little to gain by the early detection of ALS.

Shortening the time to the diagnosis of amyotrophic lateral sclerosis: role of the neurologist.

Early diagnosis is particularly relevant in the diagnosis of amyotrophic lateral sclerosis (ALS) as new therapies, which may have a direct impact on the outcome of the disease, are being developed. Many ALS patients go to non-neurological specialists rather than neurologists for their first consultation. Neurologists specialized in the field of neuromuscular diseases therefore have a duty to help general neurologists and other non-neurological specialists to recognize the disease. This may be achieved by disseminating the El Escorial/Airlie House clinical and electrophysiological criteria for the diagnosis of ALS as well as by emphasizing that ALS is a manageable condition. Neurologists should collaborate better with patient organizations as well as reinforce public awareness of ALS.

Effects of the early diagnosis of amyotrophic lateral sclerosis on the patient: advantages.

Advantages of early diagnoses in amyotrophic lateral sclerosis include validation of symptoms, avoidance of unnecessary procedures, enhanced preparation for disability and medical education. Most importantly, earlier in the course of the disease--while there is a greater motor neuron pool survival--diagnosis would enable earlier treatment intervention.

Difficulty of early diagnosis of amyotrophic lateral sclerosis: Japanese case studies

Difficulty of early diagnosis of amyotrophic lateral sclerosis: Japanese case studies

Resonancia magnética en el seguimiento clínico y terapéutico de la esclerosis múltiple

Magnetic resonance is the most sensitive para-clinical method available for the diagnosis of multiple sclerosis since it shows changes in 95% of the patients with clinically definite multiple sclerosis. However, little correlation has been found, in different studies, between the parameters of magnetic resonance and the degree of neurological disability. The development and gradual application of new techniques of magnetic resonance, which permit specific detection of the lesions with the greatest degree of nerve dysfunction, permits improvement in the use of this technique for study of the natural history of the disease and thus to monitor patients given new treatments.

The contribution of spinal cord MRI to the diagnosis and differential diagnosis of multiple sclerosis.

Imaging considerations for the diagnosis and differential diagnosis of MS are based primarily on results of MR studies of the brain. Recent studies suggest that with current technology, MR imaging of the spinal cord can make important contributions, particularly in cases with equivocal or negative brain MRI studies. Spinal cord MRI may also assume an important role in early diagnosis.

Early diagnosis of systemic sclerosis.

Nearly all patients suffering from diffuse or limited systemic sclerosis present with Raynaud’s phenomenon. These are sometimes accompanied by slight trophic skin changes like tiny, painful non-healing wounds at the finger tips. Often the underlying disease remains unknown for decades.

Evaluation of Multiple Sclerosis Disease Activity by Diffusion-Weighted MR Imaging Preliminary Comparison with Contrast-Enhanced MR Imaging

The purpose of this study was to assess the utility of cerebral diffusion-weighted MR imaging in the diagnosis of multiple sclerosis (MS) in comparison with contrast-enhanced T1-weighted imaging. We reviewed T2-weighted spin-echo (SE), fluid-attenuated inversion-recovery (FLAIR), contrast-enhanced T1-weighted SE and echo-planar diffusion-weighted images (DWIs) obtained in ten patients with definite MS on 12 occasions.In total, 83 plaques were demonstrated on T2-weighted SE and/or FLAIR images. Thirteen of these plaques showed enhancement on contrast-enhanced T1-weighted images and hyperintensity on DWIs. Five non-enhancing plaques showed hyperintensity on DWIs. Diffusion-weighted imaging, which provides information based on pathophysiology different from contrast-enhanced imaging, is a potential supplementary technique for characterizing MS plaques.