 |
September 2015 Volume 18 | Issue 5
(Supplement)
Page Nos. 1-58
Online since Friday, September 11, 2015
Accessed 76,903 times.
PDF access policy Journal allows immediate open access to content in HTML + PDF
EPub access policy Full text in EPub is free except for the current issue. Access to the latest issue is reserved only for the paid subscribers.
|
| |
|
Show all abstracts Show selected abstracts Add to my list |
|
EDITORIAL |
|
|
|
Multiples sclerosis in India |
p. 1 |
Satish V Khadilkar DOI:10.4103/0972-2327.164811 PMID:26538841 |
[HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (1) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
REVIEW ARTICLE |
 |
|
|
|
Multiple sclerosis in India: An overview |
p. 2 |
Bhim S Singhal, Hemali Advani DOI:10.4103/0972-2327.164812 PMID:26538844Multiple sclerosis (MS) is being increasingly diagnosed in India mainly due to increase in the number of practicing neurologists and easy and affordable availability of magnetic resonance imaging (MRI). The clinical features and course are largely similar to those seen in the West. The term optico-spinal MS (Asian MS) was coined in the pre-MRI days. Many such patients turn out to be cases of neuromyelitis optica - a distinct disorder and not a variant of MS. Others have shown the classical features of MS on MRI scan. Several of the disease-modifying agents, not all, are now available in India. Their use, however, has been limited in view of the high cost. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (7) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
Epidemiology and genetic aspects of multiple sclerosis in India |
p. 6 |
Rohit Bhatia, Prerna Bali, Rima Chowdhary DOI:10.4103/0972-2327.164814 PMID:26538851Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with a complex pathophysiology. Considered a rare disease in India in the past, studies over time suggest an increase in subjects with MS in India, although the observations are limited by the lack of formally conducted epidemiological studies and the absence of a nationwide registry. The current World Health Organization (WHO) Multiple Sclerosis International Federation (MSIF) "Atlas of MS" 2013 estimates a prevalence rate of 5-20 per 100,000, which also seems an underestimate. Although there have been reports of phenotypic differences between MS in Indians and the Western counterparts, recent studies report a reasonable similarity in disease types and characteristics. A few studies on the genetics of MS have been reported, including human leukocyte antigen (HLA) associations and non-major histopathology complex (MHC) disease loci. The current review discusses the pivotal studies of the past, newer observations on MS from India, and the need for a national registry. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (6) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Neuromyelitis optica spectrum disorders: An update |
p. 11 |
Lekha Pandit DOI:10.4103/0972-2327.164816 PMID:26538842Recent advances in the understanding of neuromyelitis optica spectrum of disorders (NMOSD) have expanded. Diagnostic criteria have changed over the years. The clinical spectrum of disease manifestations are now understood to include sites outside the spinal cord and optic nerve. A variety of autoimmune diseases may coexist with this disorder. Non neurological manifestations have been recently reported. Novel biomarkers other than aquoporin 4 Immunoglobulin G (anti AQP4-IgG) have been discovered which may have clinical relevance. In particul myelin associated oligoglycoprotein antibody (MOG-Ab) associated NMOSD may be relatively benign. This update describes some of these new findings highlighting the clinical manifestations, biomarkers associated with the disease and magnetic resonance imaging characteristics of brain and spinal cord. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (8) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Therapy of NMO spectrum disorders  |
p. 16 |
Atanu Biswas, Arabinda Mukherjee DOI:10.4103/0972-2327.164818 PMID:26538843Neuromyelitis optica (NMO) is an autoimmune demyelinating condition of the central nervous system often associated with aquaporin-4 (AQP4) autoantibodies manifesting as severe optic neuritis and long segment myelitis with tendency to relapse. Seronegative patients and who do not meet the NMO criteria are classified as having NMO Spectrum Disorder (NMOSD), but are treated identically to clinically definite NMO. Acute relapse is treated with intravenous methylprednisolone for 5 days with or without subsequent treatment with plasma exchange (PE). This must be followed by oral steroid to prevent rebound worsening and further relapse. For relapse prevention, immunosuppressive agents that have been found to be effective are azathioprine, rituximab, mycophenolate mofetil, methotrexate, and mitoxantrone; although none of which have been validated in randomized, controlled trial. Some patients do relapse with monotherapy, and switching to more effective agent or use of combination therapy is beneficial in such situation. There is no consensus about the duration of preventive therapy, but generally 2-3 years of relapse-free period is considered the minimum, taking into account the risks of long-term toxicity of these agents. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (3) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Systematic imaging review: Multiple Sclerosis |
p. 24 |
Aparna Katdare, Meher Ursekar DOI:10.4103/0972-2327.164821 PMID:26538845Multiple sclerosis (MS) is a chronic, inflammatory disease of the central nervous system characterised by immune-mediated demyelination, and is a leading cause of neurological disability worldwide. It has a wide spectrum of clinical presentations which overlap with other neurological conditions many times. Further, the radiological array of findings in MS can also be confused for multiple other conditions, leading to the need to look for the more typical findings, and interpret these in close conjunction with the clinical picture including temporal evolution. This review aims to revisit the MRI findings in MS, including recent innovations in imaging, and to help distinguish MS from its mimics. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (3) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Newer therapies for multiple sclerosis |
p. 30 |
Alasdair Coles DOI:10.4103/0972-2327.164824 PMID:26538846The newer immunotherapies for multiple sclerosis (fingolimod, natalizumab, dimethyl fumarate, teriflunomide, alemtuzumab) offer advantages of efficacy or tolerability over the injectable therapies of the 1990s. But they also have greater risks. As further treatments emerge (daclizumab and ocrelizumab are likely to be licensed in the next two years), the physician needs to be able to place them within a complex landscape of drugs and a specific treatment strategy, which may be an "escalation" or "induction" approach. Whilst on treatment, neurologist and patient need to be vigilant to signs of disease breakthrough or adverse effects. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (1) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
 |
Symptomatic management in multiple sclerosis |
p. 35 |
Pushkar Shah DOI:10.4103/0972-2327.164827 PMID:26538847Multiple sclerosis (MS) is the commonest cause of disability in young adults. While there is increasing choice and better treatments available for delaying disease progression, there are still, very few, effective symptomatic treatments. For many patients such as those with primary progressive MS (PPMS) and those that inevitably become secondary progressive, symptom management is the only treatment available. MS related symptoms are complex, interrelated, and can be interdependent. It requires good understanding of the condition, a holistic multidisciplinary approach, and above all, patient education and empowerment. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (5) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
Rehabilitation of multiple sclerosis patients in India |
p. 43 |
Nirmal Surya DOI:10.4103/0972-2327.164828 PMID:26538848Multiple sclerosis (MS) is a chronic progressive disease which is one of the leading causes of handicap in young subjects. The large range of symptoms associated with MS lead to continuing decline in neurologic status and quality of life. The coexistence of physical and cognitive impairments, together with the imprevisible evolution of the disease makes MS rehabilitation very challenging. The main objective of rehabilitation is, therefore, to ease the burden of symptoms by improving self-performance and independence. Inpatient, outpatient and Home rehabilitation with multidisciplinary team has been shown to be beneficial in improving disability. Individualized programs elaborated by a multidisciplinary team of experts are the key to success of rehabilitation. Family plays a big role and Family Based Rehabilitation will be important in long term rehab program in MS. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
ORIGINAL ARTICLE |
 |
|
|
 |
Acquired demyelinating disorders of central nervous system: A pediatric cohort |
p. 48 |
Sheffali Gulati, Biswaroop Chakrabarty, Atin Kumar, Puneet Jain, Harsh Patel, Lokesh Saini DOI:10.4103/0972-2327.164829 PMID:26538849Objective : This is a retrospective chart review of consecutive children with acquired demyelinating disorders presenting to a north Indian tertiary care hospital over 4 years. The aim of this review is to describe all the patients (with single event as well as those with recurrences) with detailed description of those who recurred. Materials and Methods: Overall 35 cases were reviewed and their clinical presentations, diagnosis, management, and follow-up are being presented. Results : Out of 35 cases, 24 did not show any recurrences (seven acute disseminated encephalomyelitis (ADEM) and 17 clinically isolated syndromes). Amongst the 11 patients with recurrent demyelination, majority were multiple sclerosis (8/11, 72.7%) followed by neuromyelitis optica (NMO; 2/11), and multiphasic ADEM (1/11). The median disease duration and follow-up since onset for those with recurrent episodes is 4 years (2.5-4.5 years). Steroids caused significant improvement in acute episodes of demyelination. However, recurrent demyelinating disorders like multiple sclerosis and NMO required long-term immunomodulation. Azathioprine currently is the most favored long-term immunomodulator used in NMO. Interferon-β and glatiramer acetate are currently recommended for multiple sclerosis. However, azathioprine may be a suitable alternative in a resource-limited setting. Conclusion : The consensus definitions for these groups of disorders need further validation in the pediatric age group. Studies with larger population size are required to characterize features that predict future recurrences. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (6) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|
|
CASE REPORT |
 |
|
|
 |
Multisystem involvement in neuromyelitis optica |
p. 56 |
Megan M Langille, Jay Desai DOI:10.4103/0972-2327.164830 PMID:26538850We describe a case of pediatric neuromyelitis optica (NMO) with muscle and lung involvement in addition to central nervous system disease. Our patient initially presented with features of area postrema syndrome, then subsequently with optic neuritis. The patient also had recurrent hyperCKemia that responded to corticosteroids. Finally, axillary and hilar adenopathy with pulmonary consolidation were noted as well and responded to immunomodulation. Our case highlights multisystem involvement in NMO including non-infectious pulmonary findings which have not been described in the pediatric population previously. |
[ABSTRACT] [HTML Full text] [PDF] [Mobile Full text] [EPub] [Citations (2) ] [PubMed] [Sword Plugin for Repository]Beta |
|
|
|
|
|