Exacerbations, Activity, and Progression in Multiple Sclerosis

Poser, Charles M.

doi:10.1001/archneur.1980.00500570019001

Cited by 44 publications

(7 citation statements)

References 35 publications

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“…Furthermore, lesions have been demonstrated at autopsy in asymptomatic patients in areas from which one would expect abnormal signs and symptoms to arise. 21 Whether subclinical EP changes reflect additional pathologic lesions or changes in conduction in previously diseased fiber tracts is not known. Although electropathological correlations cannot be established in our patients, the present study indicates that EPs provide information complementary to the clinical exam, and it seems reasonable to postulate that clinical and electrophysiological changes together may reflect disease activity with greater accuracy than clinical changes alone.…”

Section: Discussionmentioning

confidence: 99%

Serial Recordings of Multimodality Evoked Potentials in Multiple Sclerosis: A Four Year Follow-Up Study

Iragui¹,

Wiederholt²,

Romine³

1986

Can. j. neurol. sci.

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ABSTRACT:Pattern reversal visual, brain-stem auditory, and short latency median nerve somatosensory evoked potentials (EPs) were evaluated in a prospective study over 4 years in 20 patients with clinically definite sclerosis (MS). Standardized neurological examinations were done at regular intervals and correlated with EP findings. The highest incidence of EP abnormalities occurred in the visual system followed by the somatosensory and auditory systems. Clinical relapse was usually accompanied by EP deterioration, but clinical improvement often occurred without parallel EP recovery. EP changes were not always related to clinical symptoms and often took place during remission periods in the absence of clinical changes. There was no significant correlation between clinical and electrophysiological progression within any given sensory modality. The progression of clinical disability, however, showed a fairly good correlation with the overall progression of EP abnormalities. We conclude that EPs complement the neurological exam in the evaluation of MS and may have a place in the investigation of the effects of therapeutic agents on the neurological status in MS.

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Section: Discussionmentioning

confidence: 99%

Serial Recordings of Multimodality Evoked Potentials in Multiple Sclerosis: A Four Year Follow-Up Study

Iragui¹,

Wiederholt²,

Romine³

1986

Can. j. neurol. sci.

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“…This high relapse rate is probably a result of the frequency of clinical examinations being performed. In a publication by Poser (1980) he remarked critically on the terms 'exacerbation', 'activity' and 'progression' with regard to MS patients. He stressed the point that a temporary worsening of the clinical status does not necessarily point to an actual progression of the disease, while, on the other hand, e.g.…”

Section: Discussionmentioning

confidence: 99%

Course of multiple sclerosis

Patzold

Pocklington

1982

Acta Neurologica Scandinavica

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The course of multiple sclerosis was monitored by means of a long-term prospective study. This paper reports on first results from this study, covering 102 patients who were monitored for 2 years or more and examined regularly. It is attempted to quantify the extent of the worsening or improvement in the patients' clinical status over the period of observation using regression analysis techniques. The severity of the disease did not correlate to the period of observation in 15% of the cases, these displaying no progression with regard to the clinical signs. In most cases (32%) a description of the disease progression was possible by means of a linear regression line, 21% had a parabolic and 23.5% an increasingly progressive course. For nine patients a second or third degree polynomial regression curve could be used to describe the course of the disease. The individual progression of the disease as estimated using the linear regression coefficient did not correlate with the individual relapse rate (on average 1.1 per year), nor with the age of the patient, the severity of the multiple sclerosis, the duration of the illness or with the previous course of the disease.

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“…8 The discrepancy between clinical manifestations and ana tomical lesions in multiple sclerosis is well documented.9 In the case of micturition complaints, a poor correlation was found between symptoms and the underlying pathophysio logical condition. [3][4][5][6][7][8][9][10] In most studies, however, the urological abnormalities were not related to the severity or state of disability of multiple sclerosis. Only a few investigators stud ied this relationship by comparing urodynamic features with disease duration, physical examination, neurophysiology or disability status.3'5's*n~15 There were few patients in these latter studies (24 to 86), except in the study by Bradley,5 and nearly all patients had severe multiple sclerosis.…”

mentioning

confidence: 92%

Relationship Between Lower Urinary Tract Abnormalities and Disease-Related Parameters in Multiple Sclerosis

Koldewijn¹,

Hommes²,

Lemmens³

et al. 1995

Journal of Urology

127

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Multiple sclerosis affects the lower urinary tract in many patients. The relationship between lower urinary tract abnormalities and disease-related parameters of multiple sclerosis is not well described. We screened urologically and neurologically 212 patients according to a standard protocol. Micturition complaints were noted in 52% of the patients and urodynamic abnormalities were found in 64%. A statistical correlation was found between detrusor hyperactivity and detrusor hypoactivity with disease-related parameters, that is disease duration, disability status, myelin basic protein concentration in the cerebrospinal fluid and neurophysiological investiga tions. No relationship was found between detrusor hypersensibility or detrusor hyposensibility and the aforementioned disease-related parameters. In 1 patient upper urinary tract abnormal ities were noted in combination with urodynamic abnormalities. We conclude that lower urinary tract abnormalities can be found in every patient with multiple sclerosis unrelated to the state of the disease. Severe upper urinary tract abnormalities are rare.

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Exacerbations, Activity, and Progression in Multiple Sclerosis

Cited by 44 publications

References 35 publications

Serial Recordings of Multimodality Evoked Potentials in Multiple Sclerosis: A Four Year Follow-Up Study

Serial Recordings of Multimodality Evoked Potentials in Multiple Sclerosis: A Four Year Follow-Up Study

Course of multiple sclerosis

Relationship Between Lower Urinary Tract Abnormalities and Disease-Related Parameters in Multiple Sclerosis

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