Clinically isolated syndromes

Masjuán, Jaime; Álvarez‐Cermeño, José C.; García‐Barragán, Nuria; Díaz‐Sánchez, María; Espiño, Mercedes; Sádaba, M. C.; González-Porqué, Pedro; Millán, Jaime; Villar, Luisa M.

doi:10.1212/01.wnl.0000198253.35119.83

Cited by 121 publications

(68 citation statements)

References 16 publications

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“…Ninety four per cent of these patients presented CSF OCB at the time of the first relapse, meaning that the association of CIS and their presence could increase to 9 times the risk of CDMS conversion. Masjuan and colleagues 18 demonstrated that CSF OCB had 91.4% sensitivity and 94.1% specificity in CIS conversion to MS, which was superior to the prediction associated to abnormal brain MRI 19 . The CSF examination may show evidence of inflammatory activity during relapses as slight elevation of mononuclear white blood cells (pleocytosis) with cell counts varying between 5 to 50 cells/ mm3 in one third of MS cases.…”

Section: Introductionmentioning

confidence: 97%

Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Matas

Glehn

Fernandes³

et al. 2013

Arq. Neuro-Psiquiatr.

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The central nervous system demyelinating diseases are a group of disorders with different etiologies, characterized by inflammatory lesions that are associated with loss of myelin and eventually axonal damage. In this group the most studied ones are multiple sclerosis (MS), neuromyelitis optic (NMO) and acute disseminated encephalomyelitis (ADEM). The cerebrospinal fluid is essential to differentiate between these different syndromes and to define multiple sclerosis, helping to assess the probability of Clinical Isolated Syndrome turn into multiple sclerosis.

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Section: Introductionmentioning

confidence: 97%

Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Matas

Glehn

Fernandes³

et al. 2013

Arq. Neuro-Psiquiatr.

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“…This study had been approved by ethical committee of Al-Jadaani and Bugshan Hospitals. Patients who diagnosed MS, Table 1: Proposed diagnostic criteria for radiologically isolated syndrome [5].…”

Section: Methodsmentioning

confidence: 99%

“…According to the 2017 revision of McDonald criteria, including two major changes, irst is the early diagnosis of MS in patients with CIS with dissemination in space and +ve OCBs, without waiting for dissemination in time, second is, symptomatic or asymptomatic MRI lesions (except those in the optic nerve) can be considered as dissemination in space or time [4]. Incidental MR imaging indings resembling MS without typical MS symptoms are termed RIS, it was introduced in 2009 by Okuda to categorize incidental WM lesions suggestive of demyelinating disease in patients without typical MS symptoms and no better explanation for the MR imaging anomalies [5]. CSF analysis was one of the main paraclinical diagnostic criteria for MS (it is mandatory in the 2017 revision of McDonald criteria for MS); nowadays, it is of great importance in differential diagnosis of MS [4].…”

Section: Introductionmentioning

confidence: 99%

“…CSF analysis was one of the main paraclinical diagnostic criteria for MS (it is mandatory in the 2017 revision of McDonald criteria for MS); nowadays, it is of great importance in differential diagnosis of MS [4]. The presence of ≥2 OCBs in the CSF have a positive predictive value of 97%, negative predictive value of 84%, sensitivity of 91%, and speci icity of 94% for developing (relapsing remitting MS) RRMS after a CIS [5] (Tables 1,2). …”

Section: Introductionmentioning

confidence: 99%

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Clinically and Radiological isolated syndrome (MS risk)

Ahmed¹

2018

J Radiol Oncol

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“…One study reported that the presence of oligoclonal IgG bands is highly specific and sensitive for early prediction of conversion to MS 20 . In this last paper, the authors emphasized that the simultaneous use of both tests shows high sensitivity and specificity in predicting clinically isolated demyelinating syndrome conversion to clinically definite MS.…”

Section: Figure Risk Of Conversion From Cis To Cdmsmentioning

confidence: 99%

Beta interferons in clinically isolated syndromes: a meta-analysis

Melo

Rodrigues

Bar‐Or

2008

Arq. Neuro-Psiquiatr.

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-Beta-interferon use in definite multiple sclerosis (MS) has been proven to modify clinical and magnetic resonance imaging outcome. We review and summarize the data of published double-blind, randomized clinical trials to assess, with a meta-analysis the safety and efficacy of beta-interferon on the occurrence of relapses in patients with a first clinical event suggestive of MS. After two years of follow-up, interferon beta decreased the risk of conversion to clinically definite MS 0.51 [0.39-0.65], and delayed the time to diagnosis up to 367 days. Side-effects were mild and self limited. Our findings support the efficacy of early treatment with beta-interferon in reducing conversion to clinically defined MS in patients with clinically isolated syndromes.KEY WORDS: interferon, clinically isolated syndromes, multiple sclerosis, immunomodulating therapy. Interferons beta nas síndromes clínicas isoladas: meta-análiseResumo -Já é suficientemente conhecido que a utilização de interferon beta modifica o prognóstico clínico e de ressonância magnética em pacientes com esclerose múltipla (EM). Revisamos e sumarizamos os dados dos ensaios clínicos, duplo-cegos, randomizados e controlados com placebos para analisar, através de metaanálise, a segurança e eficácia dos interferons-beta sobre a ocorrência de recidivas em pacientes com um primeiro evento clínico sugestivo de EM. Após dois anos de seguimento, os interferons-beta diminuíram o risco de conversão para EM clinicamente definida 0,51[0,39-0,65] e retardaram o tempo para diagnóstico em 367 dias. Os efeitos colaterais foram leves e auto limitados. Nossos dados comprovam a eficácia e segurança do interferon-beta em reduzir a conversão para EM clinicamente definida de pacientes com síndromes clínicas isoladas.PALAVRAS-CHAVE: interferon, síndromes clínicas isoladas, esclerose múltipla, terapia imunomoduladora. Dr. Ailton Melo -Avenida Magalhães Neto 735 / 802 -41820-011 Salvador BA -Brasil. E-mail: asm@ufba.brMultiple sclerosis (MS) is a chronic inflammatory and degenerative disease characterized by relapsing-remitting episodes and progressive disability 1 . Although the diagnostic criteria of MS have been submitted to successive reviews, establishing the diagnosis continues to require evidence of two or more different lesions in the white matter of the central nervous system (CNS) and evidence of disease activity over time 2 . The use of magnetic resonance image (MRI) has made it possible to diagnose MS in patients with one clinical event of neurological disturbance and MRI findings suggestive of demyelinating lesions that are disseminated in time and space 3,4 . Over a decade of experience with beta-interferon (β-INF) therapies have shown these treatments decrease the frequency and intensity of relapses as well as the disease progression when used in the early phases of MS 5,6 . The mechanism of action of the β-IFN is thought to relate to decrease of the pathologic inflammatory process through immune modulation and decreased trafficking of T-helper type 1 (Th1)...

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Clinically isolated syndromes

Cited by 121 publications

References 16 publications

Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Cerebrospinal fluid analysis in the context of CNS demyelinating diseases

Clinically and Radiological isolated syndrome (MS risk)

Beta interferons in clinically isolated syndromes: a meta-analysis

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