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Biomedical subjects

I Milonas

Publications and source records attributed to I Milonas.

At least 19 recordsLinked to original sources
PubMed2006

Is there or is there not a place for anti-interferon antibodies in the decision making of multiple sclerosis treatment optimisation?

Several factors contribute to the fact that not all multiple sclerosis (MS) patients respond equally well to long-term interferon beta (IFNbeta) treatment, even if the initial response is adequate. Among these factors, anti-interferon neutralising antibodies (NAbs) may be included. There is increasing evidence that these antibodies have a clinical impact in MS treated patients, which is evident some months following the initiation of treatment with IFN?. Several efforts to reduce the concentration of NAbs, especially when they are in high titres and clinically active, have failed. However, the same efforts may be more effective if applied following early detection of the antibodies, thus leading to a continuation of the initially selected interferon treatment.

Antibodies↗
PubMed2005

Meningioma growth and interferon beta-1b treated multiple sclerosis: coincidence or relationship?

Although the coincidence of multiple sclerosis (MS) and central nervous system (CNS) tumors has been reported in over 30 cases in English literature, meningioma growth was associated with interferon-beta (INF-b) treated MS only in two of them. We report the case of a 19-year-old woman with clinically possible, laboratory supported MS, and a concomitant right intraventricular tumor with magnetic resonance imaging (MRI) characteristics consistent with meningioma (similar signal with grey matter on T1 and T2-weighted images and homogenous, intense enhancement). Two years after initiation of INF-b treatment, follow-up brain MRI revealed enlargement of the intraventricular mass and relative increase in the number of white matter lesions without significant clinical deterioration. She underwent almost total resection of the mass and histology confirmed the diagnosis of papillary meningioma. Based on the immunohistochemistry results, we speculate that INF-b resulted in meningioma growth by enhancing platelet derived growth factor (PDGF) receptors or/and down-regulating transforming growth factor receptors on the tumor itself.

Adjuvants, Immunologic↗
PubMed2003

CT and MR imaging findings in cerebral toxocaral disease.

We report serial MR findings in a 54-year-old woman with eosinophilic meningoencephalitis due to Toxocara canis infection, a parasitic disease contracted through exposure with soil contaminated by the eggs of the roundworm. MR imaging revealed several enhancing subcortical and white matter lesions in both lobes. Antihelminthic chemotherapy yielded marked improvement of the neurologic deficits and cerebral lesions. The specific MR findings-low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and contrast enhancement-and the clinical and epidemiologic features of CNS involvement are herein reviewed.

Animals↗
PubMed2002

Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient.

DESIGN: Single case report. OBJECTIVE: To report a rare case of cytomegalovirus (CMV)-associated transverse myelitis (TM) in the immunocompetent host. SETTINGS: Collaboration between a Neurology and Radiology University Department in Greece and a Molecular Virology Department in Cyprus. PATIENT: A 16-year-old male student developed an acute febrile illness followed shortly by TM, that resulted in paraplegia over 24 h. Rapid clinical improvement was followed by complete recovery in 2 months. Extensive laboratory work-up excluded other possible causes of TM and showed no evidence of an immunocompromised state. Antiviral serological data, identification of the viral genome by polymerase chain reaction and serial spinal cord magnetic resonance imaging findings, supported the diagnosis of CMV-associated TM in a non-immunocompromised patient. CONCLUSIONS: Our case further indicates that CMV infection should be included in the differential diagnosis of TM of uncertain etiology, in the immunocompetent patient. Clinical, immunological and neuroimaging findings indicate that post-infectious immune mediated inflammation, seems the most probable pathogenetic mechanism in this case.

Adolescent↗
PubMed1998

Amyotrophic lateral sclerosis: an introduction.

Amyotrophic lateral sclerosis (ALS) is a progressive, neurodegenerative disease that results in the degeneration of lower and upper motor neurones in the brain and the spinal cord. Early onset and modern therapies, including assisted ventilation, improve survival in this disease, although its cause remains uncertain. Amongst the possible causes are deficiency of nerve growth factor, deficient glutamate re-uptake, autoimmunity and mutation of superoxide dismutase 1 gene. Additional factors may be industrial pollutants and occupational exposure to chemicals associated with welding and soldering. The criteria for the diagnosis of ALS, proposed by the World Federation of Neurology, are presented together with a review of the clinical features of the disease.

Amyotrophic Lateral Sclerosis↗
PubMed1998

Cobalamin deficiency: MRI detection of posterior columns involvement and posttreatment resolution.

Cobalamin-deficient myelopathy is a neurologic disorder manifesting progressive symptoms of paresthesiae and spastic paralysis. The pathologic changes initially involve the posterior columns of the cervical and upper thoracic cord. The authors present the case of a patient with cobalamin deficiency with preferential posterior columns involvement, as evidenced by spinal magnetic resonance imaging findings. Marked clinical and radiographic resolution occurred after administration of vitamin B12. Early recognition of this specific magnetic resonance pattern is essential, because complete recovery can be achieved with prompt treatment at this reversible stage of the disease.

Follow-Up Studies↗
PubMed1992

Visual evoked potentials in hypothyroid and hyperthyroid patients before and after achievement of euthyroidism.

Thyroid hormone deficiency is frequently associated with central nervous system (CNS) disturbances such as mental retardation, convulsions, coma etc. Studies of quantitative changes in CNS in hypo- or hyperthyroidism are scarce. Evoked potentials is a good method of assessing the electrical response of the brain to different (visual, acoustic, somatosensory) stimuli and has been used extensively in the study of brain disturbances and to a lesser degree in metabolic diseases. We studied the visual evoked potentials (latency and amplitude) in 12 patients with hyperthyroidism and 15 patients with hypothyroidism, before treatment and after they became euthyroid. Four of the hyperthyroids (33%) had abnormally prolonged (> 104 msec) latencies before therapy. Two of them had clinical exophthalmos. No change was observed after euthyroidism was achieved. On the contrary 7 out of 15 (47%) hypothyroids had abnormally prolonged latencies which became normal in 4 when euthyroidism was achieved. Amplitude was lower than normal in 6 and became normal only in one of them after treatment. None of the hyperthyroid patients had amplitude changes. In conclusion, hypothyroid patients may have changes in the amplitude and/or the latency of visual evoked potentials which are reversible to a great extent with thyroxine. Evoked potentials is another method of studying in humans the metabolic effects of thyroxine deficiency in CNS.

Adult↗
PubMed1990

Epidemiology of multiple sclerosis in northern Greece.

A total of 638 new cases of multiple sclerosis (MS) (365 females, 273 males) were found from 1970-1984 in northern Greece (Macedonia and Thrace); the average annual incidence rate was 1.79 per 100,000 inhabitants with increasing incidence from 1980-1984. A total of 729 people living in northern Greece suffered from MS on December 31, 1984 (prevalence rate 29.5 per 100,000 inhabitants). No difference was found between urban and rural areas. No difference from the international standards was found for sex incidence. The study confirms the quite high prevalence of MS despite the fact that northern Greece is in the intermediate risk zone.

Adolescent↗
PubMed1987

The pharmacological effects of buflomedil in patients with multi-cerebral infarcts dementia: an open, preliminary assessment.

The influence of buflomedil on brain circulation was investigated in an open, preliminary trial in 12 patients with dementia caused by multi-cerebral infarcts. Patients were given 150 mg buflomedil 3-times daily for a period of 6 months. Assessments carried out before treatment included regional cerebral blood flow measurements, using a 133Xenon technique, as well as psychometric tests (Weschler and Benton), psychiatric and neurological evaluations, and routine clinical and laboratory (blood and urine) examinations. The tests and investigations were repeated on Days 90 and 180 of treatment. The results showed that mean regional cerebral blood flow increased by 15% to 22% and 16% to 24% in the right and left hemispheres, respectively, by the end of the trial, and marked improvements were noted in psychiatric symptoms and scores in the psychometric tests. A controlled, double-blind study is being planned to validate these preliminary findings.

Aged↗
PubMed1986

Sleep deprivation as a method of EEG activation. Observation on the incidence of positive responses.

Sleep deprivation is known to be one of the principal mechanisms to activate epileptogenic activity in the EEG recording and indeed it is one of the most common activation techniques in EEG practice. It is generally recognized that about one third of patients with seizures presenting a normal or borderline normal routine EEG may be expected to exhibit an abnormal paroxysmal recording after sleep deprivation. In the present study it was estimated that activation, by sleep deprivation, of a normal EEG into a record with abnormal paroxysmal activity, may be expected to be even higher with selection of patient population. The incidence of such activation was found to be 23% among patients presenting a history of attacks with variable clinical paroxysmal manifestations with or without impairment of consciousness, but in whom the overall picture could not be judged typically epileptic upon historical grounds alone. However, the incidence of activation was found to increase up to 57% among patients with attacks judged by history to be typical as to their epileptic nature. This higher incidence of activation appears to parallel the higher incidence of underlying abnormality as revealed by CAT scanning.

Diagnosis, Differential↗
PubMed1983

A new model of subarachnoid hemorrhage in experimental animals with the purpose to examine cerebral vasospasm.

Using 20 rabbits, we tried to establish a new model of experimental subarachnoid hemorrhage (SAH) for examining both acute and chronic cerebral vasospasm. A cranial opening was drilled, and a puncture made on the posterior branch of the middle cerebral artery. A second puncture was made in the superior sagittal sinus for additional withdrawal of subarachnoid blood. The bleeding thus induced resulted in arterial spasm which was studied by using serial electrocorticograms, cerebral blood flow measurement with 133Xe, and videomicroscopy of the small pial vessels at various intervals. After death of the animals, the brains were observed to identify the extention of the bleeding. It was indeed obvious that large amounts of subarachnoid blood clots had accumulated. This investigation showed that the rabbit can be used as a new experimental model of SAH. With a two-puncture method, it is possible to simulate the clinical phenomenon of a ruptured aneurysm, that seems to produce acute and chronic cerebral vasospasm. For the latter, the accumulation of blood clots in the basal surfaces plays an important role. The three methods of observation, videomicroscopy, cerebral blood flow measurements, and electrocorticography appeared to provide useful information in the study of biphasic vasospasm in the rabbit.

Animals↗
PubMedDate not supplied

Beneficial effect of piracetam monotherapy on post-ischaemic palatal myoclonus.

A 70-year-old hypertensive woman suffered a subarachnoid haemorrhage followed by delayed vasospasm in the basal cerebral arteries. This resulted in multiple ischaemic lesions in the right middle cerebral artery region and contralateral post-ischaemic palatal myoclonus. In this setting, piracetam administered in high doses (24-36 g/day), abolished the myoclonus observed in this patient. Although there is evidence from case reports and clinical trials of the therapeutic efficacy of piracetam in patients with skeletal myoclonus of various causes, to our knowledge this is the first report indicating the beneficial effect of piracetam monotherapy on post-ischaemic palatal myoclonus.

Aged↗
PubMedDate not supplied

Hemorrhagic cerebral infarct and ulcerative colitis. A case report.

We report the occurrence of a cerebral ischemic infarct in a young normotensive woman suffering from ulcerative colitis. One week later, clinical neurological deterioration corresponded with hemorrhagic transformation of the previously ischemic region and white matter edema. Extensive laboratory investigation excluded other possible causes for stroke mechanism and rather supported a cerebral vasculitic process, while significant improvement both on neurological and bowel function was observed under prednisone therapy. This report provides some additional support to the possible association between ulcerative colitis and cerebrovascular complications.

Adult↗