Intracerebral Hemorrhage in Multiple Sclerosis: A Retrospective Cohort Study

Zulfiqar, Maryam; Qeadan, Fares; Agrebi, I.; Farooqui, Mudassir; Richardson, Sarah Pirio; Calder, Christopher; Quadri, Syed A.; Mathur, Puja; Ford, Corey C.; Gutierrez, Santiago Ortega; Liera, Enrique; Snow, Harry; Gonzalez, Joel N.; Zafar, Atif

doi:10.1016/j.jstrokecerebrovasdis.2018.09.050

Cited by 8 publications

(3 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A retrospective cohort study done by Zulfiqar et al showed that DMD could have a protective effect against ICH in MS patients. This effect was shown to persist even after adjusted analyses for potential confounders like lifestyle factors and comorbidities [ 9 ]. An in-depth review of the mechanisms of action of the various DMDs will allow us to understand the neuroprotective and neuro-damaging properties of these drugs.…”

Section: Role Of Dmds On Ich In Ms Patientsmentioning

confidence: 99%

“…A recent retrospective cohort study showed that 0.19% of MS patients experienced ICH. To put this in perspective, the general population experiences ICH at a rate of 24.6 per 100,000 people each year, and it often leads to death [ 9 , 10 ]. It is worth noting that MS patients face a higher risk of hemorrhagic strokes [ 8 ], which adds to the overall severity of their condition.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intracerebral haemorrhage in multiple sclerosis: assessing the impact of disease-modifying medications

Ou Yong,

Awuah,

Shah

et al. 2024

Eur J Med Res

View full text Add to dashboard Cite

Multiple Sclerosis (MS) is a complex autoimmune disorder that significantly impacts the central nervous system, leading to a range of complications. While intracranial haemorrhage (ICH) is a rare but highly morbid complication, more common CNS complications include progressive multifocal leukoencephalopathy (PML) and other CNS infections. This severe form of stroke, known for its high morbidity and mortality rates, presents a critical challenge in the management of MS. The use of disease-modifying drugs (DMDs) in treating MS introduces a nuanced aspect to patient care, with certain medications like Dimethyl Fumarate and Fingolimod showing potential in reducing the risk of ICH, while others such as Alemtuzumab and Mitoxantrone are associated with an increased risk. Understanding the intricate relationship between these DMDs, the pathophysiological mechanisms of ICH, and the individualised aspects of each patient's condition is paramount. Factors such as genetic predispositions, existing comorbidities, and lifestyle choices play a crucial role in tailoring treatment approaches, emphasising the importance of a personalised, vigilant therapeutic strategy. The necessity for ongoing and detailed research cannot be overstated. It is crucial to explore the long-term effects of DMDs on ICH occurrence and prognosis in MS patients, aiming to refine clinical practices and promote patient-centric, informed therapeutic decisions. This approach ensures that the management of MS is not only comprehensive but also adaptable to the evolving understanding of the disease and its treatments.

show abstract

Section: Role Of Dmds On Ich In Ms Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intracerebral haemorrhage in multiple sclerosis: assessing the impact of disease-modifying medications

Ou Yong,

Awuah,

Shah

et al. 2024

Eur J Med Res

View full text Add to dashboard Cite

show abstract

“…(4,5) There is an increased risk for intracranial hemorrhage. (6) There are various forms of MS: relapsingremitting, acute progressive, chronic progressive, and benign. The most common form, relapsing-remitting, involves repeated periods of exacerbation and remission.…”

Section: Introductionmentioning

confidence: 99%

Effects of Massage Therapy on Multiple Sclerosis: a Case Report

Frost-Hunt

2020

IJTMB

View full text Add to dashboard Cite

Background: Multiple Sclerosis (MS) is characterized by degeneration of the myelin sheath of an axon resulting in decreased transmission of nerve impulses. It is an autoimmune disease with periods of exacerbation and remission. Types of MS include relapsing-remitting, acute progressive, chronic progressive attack-remitting, and benign. Symptoms vary from patient to patient. Common symptoms include fatigue, spasticity, swelling, and altered gait. MS is commonly treated with medications that help relieve symptoms and prolong disease progression. Massage Therapy (MT), specifically Swedish techniques, have been effective in treating MS. Objective: To examine the effects of MT on mobility, fatigue, and edema in a patient with MS. Methods: An MT student from MacEwan University’s 2,200-hour Massage Therapy program administered five MT treatments over a six-week period to a 58-year-old female diagnosed with MS 11 years earlier. She presented with symptoms of decreased mobility, fatigue, and left ankle edema. Assessment included active and passive range of motion (ROM), myotomes, dermatomes, reflexes, and orthopedic tests. Goals for the treatment sessions were to increase mobility, decrease fatigue, and decrease edema. Assessment measures included the Timed-Up-and-Go (TUG) test for mobility, the Modified Fatigue Impact Scale (MFIS) to measure fatigue, and Figure-8 ankle measurement to measure edema. Techniques used included Swedish massage, passive ROM, manual lymphatic drainage (MLD), and home-care exercises. Results: Little change was noted in mobility. The patient’s fatigue level and left ankle edema decreased. Conclusion: The results suggest that MT is effective in reducing fatigue and edema in a patient with MS. Future studies are needed to evaluate the correlation between mobility and massage.

show abstract

Prevalence and epidemiology of stroke in patients with multiple sclerosis: a systematic review and meta-analysis

Stefanou,

Giannopapas,

Kitsos

et al. 2024

J Neurol

View full text Add to dashboard Cite

Background Epidemiological data are sparse regarding the risk of stroke in patients with multiple sclerosis (MS). Objective To estimate the following: (1) the pooled prevalence of all-cause stroke, acute ischaemic stroke (AIS) and intracerebral haemorrhage (ICH) in MS patients; (2) the relative risk for all-cause stroke, AIS and ICH in MS patients compared to the general population; (3) associations between patient characteristics and the risk for AIS and ICH in MS patients. Methods Systematic review and meta-analysis of registry-based and cohort studies. Results Thirteen observational studies comprising 146,381 MS patients were included. The pooled prevalence of all-cause stroke was 2.7% (95% confidence interval [CI] 1.3–4.6%), with the relative risk of all-cause stroke being higher in MS patients compared to the general population (RR: 2.55; 95% CI 1.97–3.29). Subgroup analyses per stroke subtype revealed a pooled AIS prevalence of 2.1% (95% CI 0.8–4.1%) and a pooled ICH prevalence of 0.6% (95% CI 0.2–1.2%). Compared to the general population, patients with MS were found to harbour an increased risk for AIS (RR: 2.79; 95% CI 2.27–3.41) and ICH (RR: 2.31; 95% CI 1.04–5.11), respectively. The pooled prevalence of cardiovascular risk factors in MS patients was 11.5% (95% CI 2.9–24.7%) for dyslipidaemia, 18.2% (95% CI 5.9–35.3%) for hypertension and 5.4% (95% CI 2.1–10.2%) for diabetes. In meta-regression, age was negatively associated with AIS risk (β = – .03, p = 0.04), with a 1-year increase in age resulting in a significant 3% (95%CI 0–5) attenuation of the risk of AIS. Conclusion The findings of the present meta-analysis indicate that MS is associated with an increased risk for ischaemic and haemorrhagic stroke. Future well-designed epidemiological studies are warranted to corroborate the robustness of the present findings in the MS population.

show abstract

Intracerebral Hemorrhage in Multiple Sclerosis: A Retrospective Cohort Study

Cited by 8 publications

References 49 publications

Intracerebral haemorrhage in multiple sclerosis: assessing the impact of disease-modifying medications

Intracerebral haemorrhage in multiple sclerosis: assessing the impact of disease-modifying medications

Effects of Massage Therapy on Multiple Sclerosis: a Case Report

Prevalence and epidemiology of stroke in patients with multiple sclerosis: a systematic review and meta-analysis

Contact Info

Product

Resources

About