Multiple sclerosis diagnosis

Kurtzke JE, Wallin MT (2000) Epidemiology. In Multiple Sclerosis Diagnosis, Medical Management and Rehabilitation (Burks JS, Johnson KP, eds), pp 49-71. New York Demos Medical Publishing, Inc. 

McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol 2001 50 121-127. 

Advancement in autoimmune and inflammatory disease treatment and diagnosis represents a critical worldwide need ranking in importance only behind management of cardiovascular disease and cancer to the medical practitioner. The list of related diseases is long major classes include rheumatoid arthritis, asthma, diabetes type 1, multiple sclerosis, and inflammatory bowel disease. 

Concentration of total protein in cerebrospinal fluid is an essential biochemical parameter. It is impossible to agree with the opinion of some clinicians (many of whom are fascinated by the latest examination methods) that this is an unnecessary parameter. It is tme that the concentration of total protein in cerebrospinal fluid varies with respect to the reference range. It is known that the concentration of total protein in cerebrospinal fluid exceeding 1 g represents a principal challenge to the diagnosis of some CNS diseases (e.g., multiple sclerosis). This is fully in accordance with the results of a study (A24) in which the highest detectable level of total protein was 0.92 g... 

The presence of oligoclonal free kappa and lambda chains in CSF is a sensitive indication for recent antigenic immune response within the central nervous system, comparable with IgM. The detection of oligoclonal free kappa chains in CSF supports the diagnosis of multiple sclerosis. In addition, free light chains can also be found in the CSF of patients having inflammatory diseases of the central nervous system (LI). 

Physiological values of this formula are negative or equal to zero (software used for this purpose is able to recognize this fact) the negative values are considered to be equal to zero. Positive values indicate intrathecal synthesis of immunoglobulins and are demonstrated in 60-80% of the patients with a diagnosis of multiple sclerosis. 

Normal cytological finding—does not rule out the diagnosis of multiple sclerosis however, under practical conditions, normalization of the finding happens less frequently and usually only for a transient period. 

Serous neuroinfections—the appearance of lymphocytic pleocytosis or lymphocytic oligocytosis is present. In this case, the element count is higher than 100/3 /U.1 (35//U.1) and the probability of the diagnosis of multiple sclerosis is very low. 

We investigated 55 samples of CSF in patients with multiple sclerosis. The clinical diagnosis of multiple sclerosis was confirmed, according to common diagnostic criteria, by MRI finding and oligoclonal bands of IgG in CSF (S8). 

Stourac, R, and Bednafova, J., Intrathecal, antiviral and oligoclonal IgG synthesis in multiple sclerosis and its significance in differential diagnosis of neurological diseases. Clin. Biochem. Metab. 8(29), 204-208 (2000). 

For example, ISOLABS, Inc. has a test used to detect IgG in cerebral spinal fluid as an indicator of infection. If no neurological disease exists the concentration of IgG is less than 10% of all CSF proteins. Should multiple sclerosis be present the [IgG] will range from 11-35%. This result plus the results of other confirmatory tests can significantly aid in diagnosis. 

A9-THC is marketed as marinol or dronabinol for the treatment of chemotherapy-induced nausea and vomiting in Australia, Canada, Israel, South Africa and the USA. It was granted orphan drug status in the US for the stimulation of appetite and prevention of weight loss in patients with a confirmed diagnosis of AIDS. A9-THC is in phase I trials for spasticity, multiple sclerosis and postoperative pain. Several small clinical studies have confirmed the effectiveness of A9-THC as an analgesic, with doses of 15 to 20 mg being comparable to 60 to 120 mg of codeine (Williamson and Evans, 2000). 

Differential Diagnosis of Multiple Sclerosis Halim Fadil, Roger E. Kelley, and EAuardo Gonzalez-Toledo... 

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... 

The technique is widely used in the diagnosis of cancers, brain tumours, hydrocephalus and multiple sclerosis. It was reported in New Scientist4 that very small (4 mm) breast cancers can be detected by measuring the diffraction pattern given off by them. Figure 11.8 is a simulation of the type of image obtained from a MRI scan for a patient with multiple sclerosis. 

Rolak LA, Fleming JO (2007). The differential diagnosis of multiple sclerosis. Neurologist 13 57-72... 

There are many examples of CNS diseases where a combination of more than one CSF parameter significantly improves the accuracy of the diagnosis. Neuro-inflammatory diseases, like neuroborreliosis (Tumani et al., 1995) or multiple sclerosis (Reiber et al., 1998) are representative examples. Similarly, studies have been reported showing increased sensitivity and specificity of a combination of CSF parameters in early and differential diagnoses of AD. 

Marijuana as Medicine Twenty years ago I suddenly developed a paralysis of the right side of my body that baffled the doctors After ten months it began to improve, but I also lost my vision, and that came back Only in pan They finally were able to make a diagnosis ot multiple sclerosis. 

---