Multiple sclerosis acute

Multiple sclerosis (acute exacerbations) - 200 mg daily for a week, followed by 80 mg every other day or dexamethasone 4 to 8 mg every other day for 1 month. 

Cerebral WM changes (WMC) are found in a number of diseases of adulthood, such as the debated Binswanger s disease, multiple sclerosis, acute demyelinating encephalomyelitis, posterior reversible leukoencephalopathy syndrome, cerebral anoxia, leukodystrophies, and mitochondrial encephalopathies, among others. The term leukoaraiosis (LA) is applied for nonspecific WMC, primarily in the elderly, that cannot be attributed to a... 

Several diseases are known which are associated with BBB disruption. These include brain tumor metastases epilepsy and the more severe condition of status epilepticus cerebrovascular disorders autoimmune diseases such as multiple sclerosis acute cerebral infarcts meningeal carcinomatosis and ischemic white matter lesions. " Several genetic polymorphisms are known which increase the susceptibility to BBB disruption. These include polymorphisms in glutathione transferase, important for protection against oxidative stress, and malfunctioning variants of serum BChE (e.g., atypical BC/ffi). In particular, such mutations increase the risk of BBB disruption that is involved with exposure to anticholinesterases or to lead sulfate batteries, with subsequent increased risk for Parkinson s disease. ... 

Corticotropin is used for diagnostic testing of adrenocortical function. This drug may also be used for the management of acute exacerbations of multiple sclerosis, nonsuppurative thyroiditis, and hypercalcemia associated with cancer. It is also used as an anti-inflammatory and immunosuppressant drug when conventional glucocorticoid therapy lias not been effective (see Display 50-1). 

Miller, D.H., Thompson, A.J., Morrissey, S.P., MacManus, D.G., Moore, S.G., Kendall, B.E., Moseley, I.F. and McDonald, W.I. (1992). High dose steroids in acute relapses of multiple sclerosis MRI evidence for a possible mechanism of therapeutic effect. J. Neurol. Neurosurg. Psych. 55, 450-453. 

Uhthoff s phenomenon Acute worsening of multiple sclerosis symptoms on exposure to heat because high body temperatures may exceed the capacitance of the demyelinated nerve and conduction may fail. 

Nervous system Acute exacerbations of multiple sclerosis (MS). 

During inflammation, permeability increases in the blood-CSF barrier, elevating levels of sICAM in the CSF. Thus, in settings of acute meningitis, multiple sclerosis, and Guillain-Barre polyradiculoneuritis, CSF concentrations of 44 /rg L 4.5 ixg L and 16.2 /rg L respectively, were measured (R8). A precise, quantitative differentiation between the serum portion and the intrathecal fraction, comparable to the immunoglobulins, is still not possible therefore, the ICAM index represents the best approximation ... 

Tetranectin (TN). Tetranectin is a plasma protein of about 80 kDa. A reduction in the serum TN level has been described in malignant disease and in other conditions with tissue remodeling, whereas it does not seem to exhibit acute-phase reactant behavior. Using a polyclonal ELISA to determine the TN concentrations in pair of CSF/serum quotient in pair of CSE and serum, it was found that the CSE/serum quotient compared to the QAib was compatible with intrathecal TN synthesis. In clinically definite multiple sclerosis a reduced CSF/serum quotient was found, suggesting that the hypothesis of a reduced TN level as a marker of tissue remodeling may be extended to the CNS (C5). 

An increased IgM index is seen in cerebral lupus erythematosus and in 30-60% of multiple sclerosis patients with a short disease duration (A20, A24, L1). An increase in the IgM index is usually associated with oligoclonal IgM bands on electrophoresis. This indicates an oligoclonal aspect of intrathecally produced IgM. Cerebral IgM production is related to the activity of multiple sclerosis, and the early detection of oligoclonal IgM in patients with acute isolated lesions of the brainstem and spinal cord has more predictive value for the development of multiple sclerosis than does detection of oligoclonal IgG bands (LI). 

Assessing the effectiveness of a new drug candidate can be complex and often difficult. This is because some diseases or symptoms do not follow a predictable path. For example, acute conditions such as influenza or insomnia may resolve without intervention, while chronic conditions such as multiple sclerosis or arthritis follow a varying course of progression. Depending on age, treatment, and other risk factors, heart attacks and strokes may produce variable mortality rates. Additional difficulty is introduced by subjective evaluation, which can be influenced by the expectations of patients and physicians. Some of these issues can be addressed in controlled clinical trials. 

Azathioprine and mercaptopurine appear to be of definite benefit in maintaining renal allografts and may be of value in transplantation of other tissues. These antimetabolites have been used with some success in the management of acute glomerulonephritis and in the renal component of systemic lupus erythematosus. They have also proved useful in some cases of rheumatoid arthritis, Crohn s disease, and multiple sclerosis. The drugs have been of occasional use in prednisone-resistant antibody-mediated idiopathic thrombocytopenic purpura and autoimmune hemolytic anemias. 

Schlaug G, Siewert B, Benfield A, Edelman RR, Warach S (1997) Time course of the apparent diffusion coefficient (ADC) abnormality in human stroke. Neurology 49 113-119 Takayama H, Mihara B, Kobayashi M et al (2000) Usefulness of diffusion-weighted MRI in the diagnosis of transient ischemic attacks. No To Shinkei 52 919-923 Tievsky AL, Ptak T, Farkas J (1999) Investigation of apparent diffusion coefficient and diffusion tensor anisotrophy in acute and chronic multiple sclerosis lesions. AJNR Am J Neuroradiol 20 1491-1499... 

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