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PubMed1989

Sexual dysfunction in multiple sclerosis.

Sexual dysfunction in multiple sclerosis (MS) has only recently become recognized as an early and distressing manifestation of the disease in both sexes. Sexual problems appear to be a combination of direct neurological consequences, and of individual and partner reactions. This article reviews current knowledge about sexual dysfunction in MS. The major effects on sexual response (both organic and psychogenic) are discussed, as well as associated physical problems and implications regarding fertility, pregnancy and birth control. Guidelines for intervention by neuroscience nurses who work with MS individuals and their partners are addressed.

Adult↗

PubMedDate not supplied

A review of the aetiology of multiple sclerosis: an ecological approach.

Multiple sclerosis (MS) is a disease of unknown aetiology characterized by myelin destruction. Approaches to the aetiology of the condition have noted its differential geographic and demographic distribution; a tentative and inconsistent link with infectious agents; a genetic susceptibility; and a tendency to track with dietary lipids. This review proposes a multidisciplinary approach to the aetiology of MS, emphasizing the interlocking and interdependent nature of current aetiological arguments. We suggest that the most profitable interpretation of current empirical data on the aetiology of MS can be accomplished through this kind of analysis.

Diet↗

PubMed1990

[Clinical study and CT scanning in multiple sclerosis].

Twenty cases of multiple sclerosis were studied clinically and with CT scanning. Abnormal findings were seen on the CT scans in nine of the patients. A total of 46 focal lesions were diagnosed with clinical neurologic examination. The CT scans showed together 24 foci. On the CT scans there were 13 typical periventricular plaques which caused no evident clinical symptoms and signs in the course of the disease. Among ten patients observed with enhanced CT during the clinically acute periods, four showed evidence of demonstrable lesions. The correlation between the findings on the CT scans and the clinical manifestations discussed.

Adolescent↗

PubMed1988

A pubococcygeal exercise program for simple urinary stress incontinence: applicability to the female client with multiple sclerosis.

Five women with multiple sclerosis (MS) and simple urinary stress incontinence were informally evaluated and taught a program of pubococcygeal exercises to determine if inadvertent loss of urine during activities which increase intraabdominal pressure could be improved or eliminated. A correlation seemed to exist between the client's ability to experience vaginal contraction during sexual climax and elimination or improvement of simple urinary stress incontinence using a pubococcygeal exercise program. The purpose of this article is to encourage nurses to consider a pubococcygeal teaching program for treatment of simple urinary stress incontinence in female clients with MS who do experience vaginal contraction during sexual climax.

Exercise Therapy↗

PubMed2001

Lack of evidence for an association between two genetic polymorphisms in the tumor necrosis factor receptor 1 gene and multiple sclerosis in Ashkenazi Jews.

Multiple sclerosis (MS) is a multifactorial disease with a documented genetic component. Recent experimental models suggested a role for the tumor necrosis factor receptor 1 (TNFR1) in the pathogenesis of the disease. We compared the frequency of two polymorphisms from TNFR1, located in exon 1 and intron 6, in 94 Jewish Ashkenazi MS patients and 83 healthy Ashkenazi controls. No significant differences were observed for both polymorphisms between the patients and the controls. These findings suggest that genetic variants in TNFR1 do not play a significant role in Ashkenazi Jews.

Antigens, CD↗

PubMed2004

Does epstein-barr virus cause multiple sclerosis?

The etiology of multiple sclerosis (MS) remains unknown; however, both genetic and environmental influences undoubtedly are involved. In terms of the environment, infectious agents and random factors seem likely and there is growing evidence that MS may sometimes occur as an uncommon complication of an infection by the Epstein-Barr virus (EBV). Support for this concept, including epidemiologic considerations, persistent infection of B lymphocytes, known neurologic complications of EBV infection, serologic studies, and attempts at genome identification are reviewed. These data are consistent with EBV being a leading candidate agent in MS causation, but the evidence is not considered definitive at this time.

Epstein-Barr Virus Infections↗

PubMed2006

Diffusion-weighted MR imaging characteristics of an acute strokelike form of multiple sclerosis.

The characteristics of multiple sclerosis (MS) lesions on diffusion-weighted sequences and apparent diffusion coefficient (ADC) mapping at the very early phase of symptoms have not been clearly described. We report the case of a young woman who presented with a sudden pseudostroke form of MS resulting in hemiplegia and sudden aphasia. MR imaging showed a lesion of the left internal capsule with reduced ADC, which suggests an ischemic stroke. This case shows that very acute MS lesions may have reduced ADC on MR imaging, reflecting cytotoxic and not vasogenic edema.

Acute Disease↗

PubMed1989

Spasmodic torticollis due to a midbrain lesion in a case of multiple sclerosis.

A case of multiple sclerosis is described in which spasmodic torticollis occurred abruptly and abated after 1 year. Magnetic resonance imaging (MRI) demonstrated a lesion in the mesencephalon. Other symptoms and physical signs that developed at the same time as the spasmodic torticollis were compatible with the lesion that had not been present on MRI 18 months previously. There are very few reports of spasmodic torticollis due to an identified focal lesion; there is evidence from experimental work on animals that midbrain lesions may cause spasmodic torticollis but there has been no previous human example.

Adult↗

PubMed1997

Multiple sclerosis: a geographical hypothesis.

Multiple sclerosis remains a rare neurological disease of unknown aetiology, with a unique distribution, both geographically and historically. Rare in equatorial regions, it becomes increasingly common in higher latitudes; historically, it was first clinically recognized in the early nineteenth century. A hypothesis, based on geographical reasoning, is here proposed: that the disease is the result of a specific vitamin deficiency. Different individuals suffer the deficiency in separate and often unique ways. Evidence to support the hypothesis exists in cultural considerations, in the global distribution of the disease, and in its historical prevalence.

Climate↗

PubMed2003

[Steroid therapy for multiple sclerosis].

The cause of multiple sclerosis(MS) is still obscure. However, recent therapy is making a dramatic progress. The steroid is traditional therapy, especially the common use of methylprednisolone in management of attacks of MS is based on high-dose intravenous methylprednisolone. This section are described steroid therapy of history(ACTH therapy, High-dose intravenous methylprednisolone therapy, ACTH therapy vs high-dose intravenous methylprednisolone therapy, and long term effects of steroid therapy), high-dose oral and intravenous methylprednisolone therapy, oral therapy after steroid pulse therapy and long term effects of steroid.

Administration, Oral↗

PubMed1979

Multiple sclerosis: etiology and epidemiology.

Multiple sclerosis (MS) is a demyelinating, auto-immune disease which affect the central nervous system. The research seems to implicate a small or incomplete slow-growing virus as the causative agent. The measles virus has been suspected because of high titers of measles antibodies in MS patients' serum and cerebrospinal fluid. An immunological deficiency in MS patients may be linked to genetic factors such as HL-A tissue types and histocompatibility antigens. Genetics and socioeconomic conditions may also result in the distinct geographical pattern of MS distribution in the world.

Adolescent↗

PubMed1986

Neuropsychology of multiple sclerosis: a critical review.

Multiple sclerosis (MS) is a relatively common, chronic progressive neurological illness affecting individuals primarily in the third and fourth decades of life. Autopsy studies indicate that the disease preferentially attacks white matter throughout the CNS, including the cerebral hemispheres. This article reviews the current state of knowledge regarding cognitive dysfunction in MS and relates these findings to neuropathological changes. The view that affective disturbance may also result from cerebral demyelination is presented, along with a brief discussion of MS as a prototype "subcortical" dementia. Finally, methodological problems intrinsic to the study of MS are presented, and suggestions for future research are made.

Cognition Disorders↗

PubMed2003

[The influence of environmental factors on the incidence and prevalence of multiple sclerosis].

257 patients with multiple sclerosis (MS) participated in the study in Yaroslavl region. The main epidemiological indices (incidence and prevalence of MS) for the last 25 years were determined. The evaluation of environment pollution has been realized in different districts of the city according to the level of snow covering pollution. Farther in snow-test contents of 38 chemical elements found in industrial waste were determined and summary index of pollution of environment were calculated. Significant direct correlation is revealed between level of environment pollution and increasing of epidemiological characteristics of MS.

Adult↗

PubMed1975

Treatment with acetazolamide of brain-stem and spinal paroxysmal disturbances in multiple sclerosis.

Nine cases of multiple sclerosis with paroxysmal disorders were treated with acetazolamide. In most cases a brain-stem origin of the seizures was suggested by their particular pattern: crossed syndromes (facial spasm associated with contralateral weakness of the arm and leg, paroxysmal paraesthesiae in one side of the face and weakness of the contralateral leg), paroxysmal dysarthria, and ataxia. One patient with a Brown-Sequard syndrome complained of paroxysmal paraesthesiae in the lower limbs, for which a spinal origin was admitted. In all patients the paroxysmal disorders were promptly suppressed or markedly reduced by acetazolamide.

Acetazolamide↗

PubMed2004

Pediatric multiple sclerosis.

The onset of multiple sclerosis (MS) in childhood is being increasingly recognized. Despite this, there currently exist several barriers to the prompt diagnosis of MS in children. Many clinicians view MS as an exclusively adult-onset disease, and thus they may not entertain the diagnosis in a child. Also, the clinical and radiographic criteria for the diagnosis of MS have not been validated in a pediatric MS population. The available literature, as well as experience gained in a dedicated pediatric MS clinic, is used here to describe features of pediatric MS and contrast these with adult MS. The rationale and importance of future studies in pediatric MS is highlighted.

Adolescent↗

PubMed1985

A Markov model of the natural history of multiple sclerosis.

Prior research into multiple sclerosis prognosis has produced conflicting results. This paper presents an original approach in which the disease course is described by the movements of patients through well-defined disease states. A Markov model is proposed to describe these movements and to evaluate the effect of prognostic factors on transitions from state to state. The feasibility and applicability of this model is determined using data on the course of disease in 278 diagnosed patients from Lyon. Patients with older age at onset, females, and those with monosymptomatic onset are found to be at a higher risk of transition to a worse disease state.

Adult↗

PubMed2004

Antibody cross-reactivity between myelin oligodendrocyte glycoprotein and the milk protein butyrophilin in multiple sclerosis.

The etiology of multiple sclerosis (MS) is believed to involve environmental factors, but their identity and mode of action are unknown. In this study, we demonstrate that Ab specific for the extracellular Ig-like domain of myelin oligodendrocyte glycoprotein (MOG) cross-reacts with a homologous N-terminal domain of the bovine milk protein butyrophilin (BTN). Analysis of paired samples of MS sera and cerebrospinal fluid (CSF) identified a BTN-specific Ab response in the CNS that differed in its epitope specificity from that in the periphery. This effect was statistically significant for the Ab response to BTN(76-100) (p = 0.0026), which cosequestered in the CSF compartment with Ab to the homologous MOG peptide MOG(76-100) in 34% of MS patients (n = 35). These observations suggested that intratheccal synthesis of Ab recognizing BTN peptide epitopes in the CNS was sustained by molecular mimicry with MOG. Formal evidence of molecular mimicry between the two proteins was obtained by analyzing MOG-specific autoantibodies immunopurified from MS sera. The MOG-specific Ab repertoire cross-reacts with multiple BTN peptide epitopes including a MOG/BTN(76-100)-specific component that occurred at a higher frequency in MS patients than in seropositive healthy controls, as well as responses to epitopes within MOG/BTN(1-39) that occur at similar frequencies in both groups. The demonstration of molecular mimicry between MOG and BTN, along with sequestration of BTN-reactive Ab in CSF suggests that exposure to this common dietary Ag may influence the composition and function of the MOG-specific autoimmune repertoire during the course of MS.

Adolescent↗

PubMed1984

Evaluation of disability, incapacity and environmental status scales in multiple sclerosis.

From the Danish Multiple Sclerosis (MS) population a representative sample of 249 patients with a clinically definite diagnosis of MS has been tested by use of the Functional System Scale and Disability Status Scale of Kurtzke and the Incapacity and Environmental Status Scales of the IFMSS. Validity and reliability of the items and the properties of summed scales have been estimated. A statistical evaluation showed that generally the Incapacity and the Environmental Status Scales worked well. Problems encountered with the use of the Incapacity scale are mentioned and on statistical grounds a proposal of an incapacity scale with fewer items is presented.

Activities of Daily Living↗