Dean Wingerchuk

..The rationale and potential role for intravenous immunoglobulin in NMO will be discussed in the context of both relapse treatment and relapse prevention...

..We review recent progress in differentiating and understanding the disease mechanisms of acute disseminated encephalomyelitis, neuromyelitis optica, and classical multiple sclerosis...

..Population-based epidemiological and genetic studies, with case ascertainment aided by the high specificity of NMO-IgG and consistent disease definitions, are needed to better define and understand gender effects in neuromyelitis optica...

..The knowledge gained from further assessment of the exact role of NMO-IgG in the pathogenesis of neuromyelitis optica will provide a foundation for rational therapeutic trials for this rapidly disabling disease...

..These skills will become increasingly important to those caring for MS patients as contemporary treatment regimens become increasingly complex...

..We also recommend immunosuppression for at least 5 years in NMO-IgG seropositive patients presenting with a first-ever attack of longitudinally extensive transverse myelitis because they are at high risk for relapse or conversion to NMO...

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..This evidence is reviewed in the context of its implications for future laboratory and clinical research in NMO...

..A serum autoantibody marker, NMO-IgG, is highly specific for NMO. The authors propose revised NMO diagnostic criteria that incorporate NMO-IgG status...

..Many women with multiple sclerosis (MS) experience transient neurologic symptom worsening and fatigue in conjunction with the menstrual cycle. Aspirin reduces MS fatigue in some patients...

..Several clinical, laboratory, and neuroimaging characteristics may accurately distinguish NMO from MS early in the disease course...

..To determine whether migraine with aura and migraine without aura are independent risk factors for symptomatic cardiovascular and cerebrovascular disease...

..00002; relative risk = 0.08). The disparate natural histories of MS and NMO suggest dissociation between relapses and clinical progression in CNS demyelinating diseases...

..Relapsing NMO has a poor prognosis; therapy, typically with immunosuppression, is necessary as early as possible in the disease course to prevent attack-related disability...

..This article reviews the current state of knowledge of MS epidemiology, genetics, disease classification, natural history, and outcome measures...

..Early prediction of a relapsing course and subsequent disease severity would facilitate design and implementation of clinical trials of such therapies...

..Epidemiological and ecological studies suggest links between vitamin D deficiency and increased multiple sclerosis (MS) prevalence...

..The differences between childhood and adult ADEM, risks of development of multiple sclerosis, and the contributions of recent studies to refining the nosology of CNS demyelinating syndromes are discussed...

..Advances in understanding of its natural history and pathophysiology may eventually allow determination of whether idiopathic NMO represents a specific disease. This article summarizes recent progress in these areas of NMO research...

..This review summarizes current evidence for these 3 putative multiple sclerosis risk factors and early attempts to develop risk models and examine gene-environment interactions for this complex disease...

..012). There were no significant adverse effects. The results warrant further study and support a role for ASA-influenced mechanisms, perhaps immunologic, in the generation of MS-related chronic fatigue...

..As a sterol hormone involved in multiple immunologic pathways, vitamin D may play a role in preventing monophasic immune-mediated central nervous system attacks from developing into recurrent disease...

..To determine whether IV immunoglobulin (IVIg) reverses chronic visual impairment in MS patients with optic neuritis (ON)...

..Recurrent ON may herald multiple sclerosis (MS) or NMO, or it may occur as an isolated syndrome. The prognosis and response to therapy differs in each of these contexts...

..To analyze the frequency of neurologic events during commercial airline flights and to assess whether onboard emergency medical kits are adequate for in-flight neurologic emergencies...

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..Hopefully, the future will bring more sensitive tools for defining risk and predicting outcome, as well as more targeted and effective forms of therapy...

..We evaluated rituximab in adults with primary progressive MS (PPMS) through 96 weeks and safety through 122 weeks...

..Based on this study, future therapeutic strategies designed to limit the deleterious effects of complement activation, eosinophil degranulation and neutrophil/macrophage/microglial activation are worthy of further investigation...

..Obstructive sleep apnea (OSA) is associated with hypertension, atrial fibrillation, coronary artery disease, congestive heart failure, and diabetes. These disorders are also risk factors for stroke...

..Further refinements will eventually allow powerful longitudinal studies to assess genetic and environmental interactions with implications for prediction of individual disease susceptibility, clinical course, and response to therapy...

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..A recent American Academy of Neurology practice parameter indicated that olfactory testing was "probably useful" for differentiating idiopathic Parkinson disease (IPD) from other diseases with features of parkinsonism...

..Neuromyelitis optica (NMO) is often associated with other clinical or serological markers of non-organ-specific autoimmunity...

..Benign paroxysmal positional vertigo (BBPV) is one of the most common types of vertigo. Although the clinical presentation of this common condition is straightforward, the diagnosis and diagnostic maneuvers can be challenging...

..Other immunologic differences among NMO, NMO-spectrum disorders, and classical MS are reviewed...

..In patients with symptomatic diabetic polyneuropathy, is oral alpha-lipoic acid (ALA) effective in improving neuropathic symptoms compared with placebo?..

..Does cervical manipulative therapy (CMT) cause vertebral arterial dissection (VAD) and subsequent ischemic stroke? What is the best estimate of the incidence of CMT associated with VAD and ischemic stroke?..

..We concentrate on a recently identified serum antibody biomarker, neuromyelitis optica immunoglobulin G (NMO-IgG), which distinguishes neuromyelitis optica from multiple sclerosis...

..This case illustrates that increased intracranial pressure may in exceptional cases of spinal tumors precede the more typical myelopathic presentation by months and mimic idiopathic intracranial hypertension...

..A general approach, supported by evidence where possible, to common and contemporary clinical issues in MS care is provided in a case-based narrative...

..To assess whether antiepileptic drugs (AEDs) should be prescribed to patients with brain tumors who have no history of seizures...

..We assessed the capacity of a putative marker for neuromyelitis optica (NMO-IgG) to distinguish neuromyelitis optica and related disorders from multiple sclerosis...

..We investigated whether neuromyelitis optica (NMO) IgG seropositivity at the initial presentation of longitudinally extensive transverse myelitis (LETM) predicts relapse of myelitis or development of optic neuritis...

..CONCLUSIONS: Asymptomatic brain lesions are common in NMO, and symptomatic brain lesions do not exclude the diagnosis of NMO. These observations justify revision of diagnostic criteria for NMO to allow for brain involvement...

..Although it is conventionally believed that the brain is spared, brain imaging abnormalities are not uncommon in patients with NMO...

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..and vascular cognitive impairment, are acetylcholinesterase inhibitors (donepezil, galantamine, and rivastigmine) and N-methyl-d-aspartate (NMDA) receptor antagonists (memantine) effective in improving cognitive function over placebo?..

..These findings strongly support a role for a complement activating AQP4-specific autoantibody as the initiator of the NMO lesion, and further distinguish NMO from MS...

..To systematically review available evidence regarding whether second-generation antiepileptic drugs (AEDs) contribute to the risk of balance disorders...

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..The development of animal models and further analysis of the association of NMO-IgG with disease severity and treatment response will elucidate the pathobiology of NMO...

..To determine whether a diagnosis of idiopathic rapid-eye-movement sleep behavior disorder (RBD) is associated with a future risk of development of neurodegenerative diseases...

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..Identification of clinical features that reliably distinguish PNES from ES would be valuable in acute care settings, for patients that have coexisting disorders, and those with multiple event types...