Article abstract-Objective: An epidemiologic survey was conducted to determine the prevalence and incidence of MS in the city of Catania, Sicily, Italy. Prevalence rate was calculated as point prevalence at January 1,1995, and incidence during 1974 to 1995. Methods: The authors studied the frequency of MS in the community of Catania in a population of 333,075 inhabitants according to the 1991 census. The primary sources for the case ascertainment were the neurologic and motor rehabilitation departments, the MS Center, the Italian MS Association, private neurologists, and family doctors. All patients who satisfied the Poser criteria for clinically definite MS, laboratory-supported definite MS, clinically probable MS, and laboratory-supported probable MS were considered prevalent and incident cases. Results: One hundred ninetyfive patients with MS who had had the onset of disease on prevalence day in a population of 333,075 inhabitants were detected. The prevalence rate was 58.5 per 100,000 (95% CI 50.7 to 67.5). Prevalence was higher in women (62.0/100,000) than in men (54.8/100,000). The age-specific prevalence showed a peak in the group aged 35 to 44 (145

The eVects of combined treatment with cyclophosphamide (CTX) and interferon-(IFN-) are described in selected patients with "rapidly transitional" multiple sclerosis. This form of multiple sclerosis is extremely active with very frequent and severe attacks which produce a dramatic increase on the expanded disability status scale (EDSS). Ten patients with rapidly transitional multiple sclerosis were previously treated with interferon-, but none benefited by this treatment. Monthly treatment with intravenous CTX, from 500 mg/m 2 to 1500 mg/m 2 to obtain a chronic lymphocytopenia (600/mm 3 to 900/mm 3 ) produced a marked and significant reduction in the number of relapses (p<0.0001), disability previously accumulated (p<0.0001), and a reduction of T2 MRI burden of lesion. This particular group of patients benefited by combining cyclophosphamide and IFN-. The possibility is considered of carrying out further studies to test the eYcacy of the association between the two drugs for patients who are not responsive to IFN-or other active disease modifying therapies. (J Neurol Neurosurg Psychiatry 2001;71:404-407)

We describe a case of genetic Creutzfeldt-Jakob disease (CJD) with deafness at the onset. We report clinical features, 14-3-3 protein positivity, electroencephalography and brain stem auditory evoked potential abnormalities, and high signal on magnetic resonance imaging in basal ganglia and temporal cortex. Similarities with CJD Heidenhain variant are discussed.

Objectives‐ To evaluate clinical and MRI effects of natural interferon β treatment in both relapsing‐remitting (RR) and secondary‐progressive (SP) multiple sclerosis patients. Material and methods‐ A double‐blind, randomized trial of natural interferon β (nIFN‐β) in 58 ambulatory patients with RR and 40 with SP multiple sclerosis. Forty‐nine patients (29 RR and 20 SP) were treated with intramuscular nIFN‐β 6 MIU three times a week for 24 months and 49 control patients were treated with placebo. Results‐ Primary clinical endpoints were differences in exacerbation rates and proportion of patients remaining exacerbation‐free. There were no significant baseline differences between the treated and placebo groups. In the treated RR group a significant reduction in exacerbation rate, an increase in the probability of remaining exacerbation‐free, and an improvement in mean EDSS were found at 24 months. MRI activity and total lesion burden were significantly reduced in treated RR patients. In the SP group, nIFN‐β produced a significant reduction in EDSS score, a significant reduction in active lesion number, a marginally significant favourable difference in total lesion burden but no significant effect on the number of gadolinium‐enhancing lesions. Side effects were transient and mild in treated patients. Conclusions‐ These observations confirm that nIFN‐β is a promising and well‐tolerated treatment for either RR or SP MS patients.

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