Benign course of tumour-like multiple sclerosis… [J Neurol Sci. 2013] – PubMed – NCBI

Posted on January 1, 2013 by Maurice Preter MD

J Neurol Sci. 2013 Jan 15;324(1-2):156-62. doi: 10.1016/j.jns.2012.10.026. Epub 2012 Nov 11.

Benign course of tumour-like multiple sclerosis. Report of five cases and literature review.

Turatti M, Gajofatto A, Bianchi MR, Ferrari S, Monaco S, Benedetti MD.

Source

The Section of Clinical Neurology, Department of Neurological, Neuropsychological, Morphological and Motor Sciences, University of Verona, Italy.

Abstract

BACKGROUND:

Multiple sclerosis (MS) with initial neuroradiological features suggestive of brain tumour (tumour-like MS) may represent a challenging diagnosis.

METHODS:

Among the patients seen at the MS centre of our Institution between 2000 and 2010, we identified cases presenting with a large (diameter>2cm), well-defined lesion, suggestive of brain tumour on initial brain magnetic resonance imaging (MRI). Only patients with at least 10years follow-up were included.

RESULTS:

Five young women with MS who presented with a tumour-like lesion on initial brain MRI are described. All cases presented with sudden-onset neurological deficits due to a single large brain lesion compatible with neoplasm at MRI. Two cases underwent brain stereotactic biopsy, both misdiagnosed as astrocytoma. However, the subsequent clinical and MRI follow-up was consistent with MS in all cases. Unnecessary surgery and radiotherapy were responsible for disability in two cases. In three cases, the course of the disease remains benign after more than 13years from symptoms onset.

CONCLUSIONS:

Our report of clinical, radiological and pathological features of five tumour-like MS cases confirms that it is mandatory to consider a demyelinating process in the differential diagnosis of tumour-like brain lesions. Many tumour-like MS cases may have a favourable long term prognosis.

Copyright © 2012 Elsevier B.V. All rights reserved.

PMID:

23151425

[PubMed – in process]

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Suicide risk in multiple sclerosis: A system… [J Psychosom Res. 2012] – PubMed – NCBI

Posted on January 1, 2013 by Maurice Preter MD

J Psychosom Res. 2012 Dec;73(6):411-7. doi: 10.1016/j.jpsychores.2012.09.011. Epub 2012 Oct 12.

Suicide risk in multiple sclerosis: A systematic review of current literature.

Pompili M, Forte A, Palermo M, Stefani H, Lamis DA, Serafini G, Amore M, Girardi P.

Source

Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Italy; McLean Hospital, Harvard Medical School, USA. Electronic address: maurizio.pompili@uniroma1.it.

Abstract

BACKGROUND:

Studies have shown that suicidal ideation is often revealed among patients suffering from Multiple Sclerosis (MS). Mental health assessment of physically ill patients should form part of routine clinical evaluation, particularly in chronic illness.

OBJECTIVE:

The aim of the present paper was to investigate whether there was a relationship between MS and suicidal behavior.

METHODS:

A systematic review of the literature was conducted to determine the potential association between MS and suicidal behavior. A total of 12 articles from peer-reviewed journals were considered and selected for this review.

RESULTS:

Most studies have documented a higher suicide rate in patients with MS compared to the general population, and suicide was associated with several risk factors: Depression severity, social isolation, younger age, progressive disease subtype, lower income, earlier disease course, higher levels of physical disability, and not driving.

CONCLUSIONS:

Clinicians should be aware of the fact that suicidality may occur with higher frequency in MS patients, the available data suggest that the risk of self-harm is higher than expected in MS patients.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID:

23148807

[PubMed – in process]

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Curcuminoids in neurodegenerative… [Recent Pat CNS Drug Discov. 2012] – PubMed – NCBI

Posted on January 1, 2013 by Maurice Preter MD

Recent Pat CNS Drug Discov. 2012 Dec;7(3):184-204.

Curcuminoids in neurodegenerative diseases.

Kim DS, Kim JY, Han Y.

Source

Core LifeSource Inc. 5100 Newport Dr. Suite # 10, Rolling Meadows, IL 60008, USA. calebin@gmail.com

Abstract

Neurodegeneration is a term used to describe progressive deterioration of structure and/or function of neurons that affects different parts of the central nervous system and leads to eventual death. Neurodegenerative diseases include Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), Huntington’s disease (HD), and Down’s syndrome (DS), multiple sclerosis (MS), glaucoma, age-related macular degeneration (AMD), and diabetic encephalopathy (DE). Although the initial events that trigger these disorders may be different from each other, they share similar biochemical reactions that lead to neurodegeneration. Curcuminoids, polyphenol compounds from turmeric (Curcuma longa), possess diverse biological properties that modulate debilitating biochemical processes involved in AD that include attenuation of mitochondrial dysfunction-induced oxidative stress and inflammatory responses to inflammatory cytokines, COX-2, and iNOS. Curcuminoids also bind to β-amyloid (Aβ) plaques to inhibit amyloid accumulation and aggregation in the brain, in addition to inhibiting the toxic Aβ oligomer formation and oligomer-dependent Aβ toxicity. These properties can be further elaborated to DS, glaucoma and AMD. Curcuminoids also prevent α-synuclein aggregation in PD; attenuate ROS-induced COX-2 expression in ALS; ameliorate the symptoms of MS, DE and traumatic brain injury, in addition to neurodamages caused by heavy metal poisoning. These results demonstrate curcuminoids may be potentially effective therapeutic means to treat neurodegenerative diseases. A bulk of patents discloses methods to improve bioavailability of curcuminoids for therapeutic development. This review provides a comprehensive description on the current progress on curcuminoids against neurodegenerative diseases.

PMID:

22742420

[PubMed – in process]

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Vitamin D and multiple sclerosis: a critica… [Acta Neurol Belg. 2012] – PubMed – NCBI

Posted on January 1, 2013 by Maurice Preter MD

Vitamin D and multiple sclerosis: a critica… [Acta Neurol Belg. 2012] – PubMed – NCBI.

Acta Neurol Belg. 2012 Dec;112(4):327-33. doi: 10.1007/s13760-012-0108-z. Epub 2012 Jul 6.

Vitamin D and multiple sclerosis: a critical review and recommendations on treatment.

Faridar A, Eskandari G, Sahraian MA, Minagar A, Azimi A.

Source

Department of Neurology, University of California, San Francisco, USA.

Abstract

Multiple sclerosis (MS) is an immune-mediated and degenerative disease of nervous system, which affects mostly young adults. Vitamin D deficiency is a well-known environmental risk factor for MS and is considerable in terms of immediate clinical implications. In addition to its classical action on regulation of bone homeostasis, vitamin D may have a potent impact on cytokine profiles and neuro-inflammation. Given the immunomodulatory effects of vitamin D and its high rate of deficiency in MS patients, prescribing vitamin D is a remarkable issue in MS. The results from several experimental and clinical studies indicate that vitamin D supplementation may ameliorate the inflammation during the relapse phase and attenuate disease progression. We present the experimental and clinical studies, which assessed the effects of vitamin D on the pathophysiology, prevalence and management of MS. The authors also discuss current recommendations on prescription of this vitamin to MS patients.

PMID:
22767049
[PubMed – in process]

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Current Affairs: Hillary Clinton’s Illness and Prognosis of Cerebral Venous Thrombosis

Posted on January 1, 2013 by Maurice Preter MD

 

Our classic long-term follow up of CVT. Fulltext is available here, courtesy of Stroke:

Long-term Prognosis in Cerebral Venous Thrombosis

Follow-up of 77 Patients

  1. Maurice Preter, MD;
  2. Christophe Tzourio, MD;
  3. Alain Ameri, MD;
  4. Marie-Germaine Bousser, MD

+ Author Affiliations


  1. From the Department of Neurology, Albert Einstein College of Medicine, Bronx, NY (M.P.); INSERM, U 360, Recherches Epidémiologiques en Neurologie et Psychopathologie, La Salpêtrière, Paris (C.T.); Service de Neurologie, Hôpital de Meaux, Meaux (A.A.); and Service de Neurologie, Hôpital Saint-Antoine, Paris (M.-G.B.), France.

Abstract

Background and Purpose Very little is known about the long-term outcome of patients with cerebral venous thrombosis (CVT), particularly regarding the risk of residual epilepsy and further thrombotic events. We retrospectively studied 77 patients with CVT diagnosed by angiography and/or MRI.

Methods A cohort of 77 patients aged 18 to 77 (mean, 38.5) years with CVT, evaluated from 1975 through 1990, was followed up for a mean of 77.8 months (range, 14 to 204 months; median, 63 months). Information on death, neurological status, seizures, recurrent CVT, other thrombotic events, and subsequent pregnancies was obtained from direct observation, mail questionnaire, or telephone interviews.

Results Sixty-six of 77 patients (85.7%) had no neurological sequelae during follow-up. Eleven patients (14.3%) remained neurologically impaired. Two who initially presented with isolated intracranial hypertension had blindness due to optic atrophy. The other 9 had focal signs at the time of CVT and were left with various cognitive or focal deficits. Four of 28 (14.3%) patients who had seizures at the acute stage had recurrent seizures. One of the 51 patients with lateral sinus thrombosis developed a dural arteriovenous fistula. Nine of the 77 patients (11.7%) suffered a second CVT, all but one in the first year. Noncerebral thrombotic events occurred in 11 patients (14.3%). No recurrence of CVT occurred during later pregnancies, but 1 patient had a postpartum deep vein thrombosis.

Conclusions In the present series, CVT has an essentially good long-term prognosis. The frequency of long-standing epilepsy was low, suggesting that long-term anticonvulsant treatment is not necessary in the majority of cases. A second CVT or another thrombotic episode occurred in 20% of patients, stressing the need in a minority of cases for long-term anticoagulation.

Key Words:

 

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