[disseminated sclerosis, multiple sclerosis, spinal]- In one case plaques of multiple sclerosis were found in the spinal cord. Those two cases are unusual forms of a diffuse disseminated sclerosis: multiple sclerosis and Schilder's disease are considered as two anatomo-clinical variants of the same pathological process. The observed necrotic lesions are different from the acute necrotic forms of multiple sclerosis as the latter have rapidly developed..[Lhermitte:1982]{Human}
[disseminated sclerosis, multiple sclerosis, treatments]- An analysis was performed of features of incipient manifestations of multiple sclerosis in 648 patients with a primary diagnosis having been made at the Ukrainian Centre for Study of Demyelinating Diseases over 1992-1996. Incipient manifestations of disseminated sclerosis revealed themselves predominantly as sensory, motor, visual, and coordination impairment against the background of pain sensations, paresthesias and pronounced asthenia of the nervous system. Knowledge of disseminated sclerosis debut is important for the diagnosis of the condition to be made and treatments to be administered in a timely fashion..[Vinychuk:1998]{Human}
[chronic cerebro-spinal venous insufficiency, multiple sclerosis]- The Chronic Cerebro-Spinal Venous Insufficiency, recently described as a possible role in Multiple Sclerosis pathogenesis, is diagnosed and classified with Echo Color Doppler (ECD) examination of the extra- and intra-cranial veins..[Maria:2012]
[disseminated sclerosis, multiple sclerosis, therapy/treatment]- In the material of patients with trigeminal neuralgia treated by retrogasserian glycerol injection at the Karolinska Hospital, 23 cases (8%) were also diagnosed as suffering from disseminated sclerosis. These patients were often on carbamazepine treatment before the procedure, a regimen known to cause severe side effects and increase pre-existing symptoms in patients with multiple sclerosis. Following glycerol injection, more than 90% became pain-free within the first 2 months and 82% could discontinue drug therapy. This initial outcome corresponds well to the results in our larger series, but the long-term results in the group with multiple sclerosis is less satisfactory, with 61% recurrence at follow-up 8-79 months following treatment..[Linderoth:1989]{Human}
[ccsvi, chronic, insufficiency, multiple sclerosis, venous, venous insufficiency]- Chronic cerebrospinal venous insufficiency ( CCSVI) is a vascular picture that shows a strong association with multiple sclerosis (MS). The aim of this study was to investigate the relationship between a Doppler cerebral venous hemodynamic insufficiency severity score (VHISS) and cerebrospinal fluid (CSF) flow dynamics in 16 patients presenting with CCSVI and relapsing-remitting MS (CCSVI-MS) and in eight healthy controls (HCs)..[Zamboni:2009]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the " venous hemodynamic insufficiency severity score" (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits [2]. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints..[Reekers:2011]
[ccsvi, chronic, multiple sclerosis, spinal, venous, venous insufficiency]- Recent clinical studies have suggested a relationship between multiple sclerosis (MS) and the occurrence of pathological changes in the jugular, vertebral and azygous veins that result in abnormal blood outflow from the brain and the spinal cord. Together, these pathological changes have been designated chronic cerebrospinal venous insufficiency ( CCSVI). The aim of the present study was to evaluate the usefulness of duplex Doppler ultrasound in the evaluation of central nervous system venous outflow disturbances in patients suffering from MS..[Zaniewski:2012]
[ccsvi, chronic, multiple sclerosis, treatments, venous, venous insufficiency]- The aetiology proposed for the development of chronic cerebrospinal venous insufficiency ( CCSVI) associated with multiple sclerosis (MS) has been the presence of congenital truncular venous malformations. However, this hypothesis is not consistent with the epidemiology or geographical incidence of MS and is not consistent with many of the ultrasonographic or radiographical findings of the venous disturbances found in MS patients. However, the probability of a venous aetiology of MS remains strong based on evidence accumulated from the time the disorder was first described.The method used in this review was to search PubMed for all past medical publications related to vascular, venous, haematological, epidemiological, biochemical, and genetic investigations and treatments of MS.Epidemiological and geographical findings of prevalence of MS indicate the involvement of an infective agent. This review of the venous pathology associated with MS describes a hypothesis that the pathogenesis of the venous disease could be initiated by a respiratory infective agent such as Chlamydophila pneumonia, which causes a specific chronic persistent venulitis affecting the cerebrospinal venous system..[Thibault:2012]
[chronic, multiple sclerosis, name, treatment, venous insufficiency]- The aetiology of multiple sclerosis remains unknown at the present time, although the most likely explanation is that it has an autoimmune inflammatory origin. During the history of this disease a vascular pathophysiology was once proposed, and it has recently re-emerged as a result of the work by Paolo Zamboni with the name of ' chronic cerebrospinal venous insufficiency'. Following this hypothesis, Zamboni puts forward a curative treatment for multiple sclerosis by means of endovascular treatment of the internal jugular vein and the azygos vein..[Carmen:2011]
[ccsvi, chronic, numerous, multiple sclerosis, venous, venous insufficiency]- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome recently described in multiple sclerosis patients. It is characterized by abnormal venous hemodynamics resulting from numerous obstacles in the main veins draining the central nervous system, usually: the internal jugular veins and the azygous vein..[Ma'moon:2012]
[ccsvi, chronic, multiple sclerosis, treatment, venous, venous insufficiency]- Chronic cerebrospinal venous insufficiency ( CCSVI) was recently described in multiple sclerosis patients. CCSVI is characterized by impaired brain venous drainage due to outflow obstruction in the extracranial venous system, mostly related to anomalies in the internal jugular and azygos veins. The current CCSVI diagnosis is based on Doppler sonography of extracranial and transcranial venous hemodynamics criteria. To date, prevalence estimates of CCSVI, provided by different groups using various imaging methods of assessment, vary widely from none to 100%. There is an urgent need to define and validate the spectrum of cranial/extracranial venous anomalies and to establish reliable, diagnostic gold-standard test(s). The potential usefulness of endovascular treatment for CCSVI in multiple sclerosis patients is still unknown..[Robert:2011]{Human}
- Multiple sclerosis (MS) is a chronic disease of the central nervous system with not yet completely understood pathogenesis. The so called " chronic cerebrospinal venous insufficiency ( CCSVI) theory" has recently emerged, supporting the concept of a cerebrospinal venous drainage impairment as the cause of MS. Since the first publication on this topic with a claimed 100% specificity and sensitivity of the condition for MS diagnosis, CCSVI theory has generated a scientific and mass media debate with a great hope for the miracle of a new possible endovascular treatment of MS ("liberation procedure"). We critically summarize the available evidence on CCSVI discussing inconsistent and incomplete replication of the original results by different groups, methodological limitations and potential therapeutic implications. We conclude that the available data are insufficient to establish conclusively a clear relationship between MS and CCSVI and do not support the role of CCSVI as the primary cause of MS. Until credible scientific evidence replicates the original results, any proposed invasive treatments of CCSVI should be discouraged..[Chiara:2011]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure..[Zamboni:2010]{Human}
[chronic, multiple sclerosis, venous, venous insufficiency]- The discovery of stenoses in the azygous and internal jugular veins, the so-called chronic cerebrospinal venous insufficiency that accompanies multiple sclerosis, has enabled the reinterpretation of knowledge about this neurologic disease. Pathologic venous outflow from the central nervous system appears to lead to two main problems..[Marian:2012]
- The prevailing view on multiple sclerosis etiopathogenesis has been challenged by the suggested new entity chronic cerebrospinal venous insufficiency. To test this hypothesis, we studied 21 relapsing-remitting multiple sclerosis cases and 20 healthy controls with phase-contrast magnetic resonance imaging. In addition, in multiple sclerosis cases we performed contrast-enhanced magnetic resonance angiography. We found no differences regarding internal jugular venous outflow, aqueductal cerebrospinal fluid flow, or the presence of internal jugular blood reflux..[Peter:2010]{Human}
[ccsvi, chronic, multiple sclerosis, venous, venous insufficiency]- The aim of this study was to investigate whether a combination of Doppler sonography (DS) and magnetic resonance venography (MRV) on 3T MRI increases specificity for detection of chronic cerebrospinal venous insufficiency ( CCSVI) in 171 (113 relapsing-remitting, 47 secondary-progressive, 11 primary progressive) patients with multiple sclerosis (MS) and 79 age- and sexmatched healthy controls (HCs). One hundred ten (64.3%) MS patients and 30 (38%) HCs presented ≥2 venous hemodynamic CCSVI criteria (p<.0001). Both DS and MRV showed relatively high specificity but lower sensitivity for determining a CCSVI diagnosis in patients with MS vs HCs and between MS subgroups..[Dolic:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Ultrasound and venographic studies of the internal jugular and azygos venous systems in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 71%, range 0-100%; n=1336) associated with activation of collaterals..[Nicolaides:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a hypothesis through which cerebral venous drainage abnormalities contribute towards the pathogenesis of multiple sclerosis. CCSVI venoplasty is already practised worldwide. We report the case of a 33-year-old lady with multiple sclerosis who underwent left internal jugular venoplasty resulting in iatrogenic jugular thrombosis requiring open thrombectomy for symptom relief..[null:2011]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) has been postulated as a cause for multiple sclerosis (MS). Venous pressure assessments have not been made. Intracranial venous pressure was assessed using ophthalmodynamometry in 29 MS patients and compared with 28 healthy controls and 19 cases with elevated intracranial pressure (ICP). MS and control subjects had normal venous pressures (mean 15.5 resp. 15.1 cmHg). Only cases with intracranial pressure pathology had elevated venous pressures (mean 28.8 cmHg). There is no evidence of an increased intracranial venous pressure in MS patients..[Rolf:2011]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Studies using ultrasound in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 70%; range 0-100%; N.=1496), whereas, in normal controls and patients without MS the prevalence was much lower (mean 10%; range 0-36%; N.=635). Ultrasound uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results..[Zamboni:2012]
- Zamboni et al proposed a new hypothesis for the pathomechanisms of multiple sclerosis (MS): chronic cerebrospinal venous insufficiency ( CCSVI). Using Doppler ultrasound and venograms, they found severe extracranial venous stenosis in MS patients. They suggested that a venous obstruction in the neck caused a reflux back into the brain, which led to edema and demyelination..[Masami:2011]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a term used to describe impaired venous drainage from the central nervous system (CNS) caused by abnormalities in anatomy and flow affecting the extracranial veins. Recently, it has been proposed that CCSVI may contribute to the pathogenesis of multiple sclerosis (MS). It is hypothesized that venous obstruction results in abnormal flow that promotes inflammation at the blood-brain barrier and that this triggers a process marked by a disturbance of homeostasis within the CNS that leads to demyelination and neurodegeneration. The venous abnormalities of CCSVI are often diagnosed by ultrasound or magnetic resonance venography, however the prevalence of CCSVI detailed in groups of MS patients and patients without MS varies widely in published reports. Increased standardization of diagnostic studies to evaluate both anatomical and physiological findings associated with CCSVI is needed. The purpose of this article is to provide a background to understand the development of the theory of CCSVI and to frame the relevant issues regarding its diagnosis and relationship to the pathogenesis of MS..[Dake:2012]
[ccsvi, chronic, multiple sclerosis, treatment, venous insufficiency]- Chronic cerebrospinal venous insufficiency ( CCSVI) was recently proposed as a contributing factor in the pathology of multiple sclerosis. This concept has gained remarkable attention, partly because endovascular neurointervention has been suggested as a treatment strategy..[Amer:2011]
[chronic, multiple sclerosis, spinal, therapies, treatment]- Here, we report on 3 cases with chronic progressive multiple sclerosis who have undergone the pulse-dose cyclophosphamide treatment. The cases included 3 women, two with primary progressive multiple sclerosis (one, the classical form and the other, the spinal cord from). The 3rd case was that of myelitis-optic neuritic form and the total blindness of right eye (left side had been totally blind) was impending despite repeated corticosteroid therapies..[Watanabe:1993]{Human}
[cerebro spinal, multiple sclerosis, therapy/treatment]- A patient with ankylosing spondylitis developed a neurological disorder suggesting multiple sclerosis. An increased level of gammaglobulin was detected in the analysis of the cerebro spinal fluid. The response to steroid therapy, however, was unusual to that of multiple sclerosis since clinical manifestations disappeared shortly after, recurred some months later after discontinuance of the treatment, and subside again when the administration of corticosteroids was repeated..[Garc?a:1980]{Human}
[multiple sclerosis, multiple treatment, spinal, treatments]- Spasticity occurs in children and adults due to a wide range of conditions, including cerebral palsy, head and spinal cord trauma, cerebrovascular accidents and multiple sclerosis. Multiple treatment options have been described, including medical and surgical treatments..[von:2001]{Human}
[chronic, multiple sclerosis, venous insufficiency]- A critical analysis of the scientific methods used in the original studies of chronic cerebrospinal venous insufficiency in multiple sclerosis reveals several methodological problems with regard to potential bias and confounding. The current evidence calls into question whether chronic cerebrospinal venous insufficiency in multiple sclerosis exists at all..[Bridget:2011]{Human}
- Key Points • Chronic cerebrospinal venous insufficiency is a controversial topic in multiple sclerosis. • Ultrasound assessment of extracranial veins has yielded different results in the literature. • These differences may be due to dependence on Doppler and selection bias. • We found variations in vertebral vein flow in patients with multiple sclerosis..[Fatih:2011]
- We aim to present a very rare case of chronic cerebrospinal venous insufficiency due to both brachiocephalic vein obstruction by aberrant right subclavian artery and internal jugular vein distal compression by first cervical vertebra transverse process, demonstrated by multislice computerized tomography in a patient with multiple sclerosis..[Djordje:2012]
- Chronic cerebrospinal venous insufficiency has recently been proposed to be etiologic to multiple sclerosis..[Bridget:2011]{Human}
- Multiple sclerosis is highly correlated with chronic cerebrospinal venous insufficiency..[Simka:2010]{Human}
- Our findings showed a positive association between chronic cerebrospinal venous insufficiency and multiple sclerosis..[Andreas:2011]{Human}
- Concepts of multiple sclerosis (MS) have shifted from the traditional view of a T cell-mediated, demyelinating disease of the white matter to include a broad range of immunopathogenic mechanisms, axonal damage, and widespread gray matter pathology. The cause of MS remains unknown, but recent epidemiological work has focused on genetic factors; environmental factors such as vitamin D, sunlight, and Epstein-Barr virus; and the controversial theory of chronic cerebrospinal venous insufficiency..[Daniel:2012]
[ccsvi, chronic, multiple sclerosis, venous insufficiency]- This study aimed to evaluate the prevalence of chronic cerebrospinal venous insufficiency ( CCSVI) in patients with multiple sclerosis (MS)..[Floris:2012]
- The Canadian Institutes of Health Research and the Multiple Sclerosis (MS) Society of Canada recently convened an Invitational Panel to consider the scientific evidence linking chronic cerebrospinal venous insufficiency ( CCSVI) and MS. The panel supported studies to determine whether CCSVI causes MS, but felt that there is currently so much uncertainty about the relationship between CCSVI and MS that a clinical trial is not indicated at this time..[Andreas:2011]
- Cerebrospinal fluid (CSF) flow dynamics, which supposedly have a strong relationship with chronic cerebrospinal venous insufficiency ( CCSVI), might be expected to be affected in multiple sclerosis (MS) patients..[Gorucu:2012]
- A new nosologic vascular pattern that is defined by chronic cerebrospinal venous insufficiency ( CCSVI) has been strongly associated with multiple sclerosis..[Paolo:2009]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) represents a recently described condition that may potentially contribute to the symptoms experienced by patients with multiple sclerosis. The evaluation of a prospective patient for CCSVI often involves an invasive evaluation with venography of the internal jugular and azygos veins. The purpose of this article is to review the normal anatomy of the internal jugular, vertebral, and azygos veins, as an understanding of these veins is necessary for appropriate interpretation of the venograms obtained to evaluate patients for CCSVI..[John:2011]
- Background Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system, believed to be triggered by an autoimmune reaction to myelin. Recently, a fundamentally different pathomechanism termed ' chronic cerebrospinal venous insufficiency' ( CCSVI) was proposed, provoking significant attention in the media and scientific community..[Christoph:2011]
[chronic, multiple sclerosis, spinal, treatments]- Multiple sclerosis (MS) is a chronic neurological condition characterized pathologically by axonal loss, demyelination, inflammation, and gliosis. Magnetic resonance imaging (MRI) has had a major impact on diagnosing MS, understanding the condition, and monitoring the effects of treatments. Recently, spinal cord MRI has received increased attention. Advanced techniques have been used to image the spinal cord, particularly the cervical cord, and measure quantitative parameters such as T1 relaxation time, magnetization transfer ratio, and diffusivity..[Christopher:2005]{Human}
[ccsvi, chronic, multiple sclerosis, treatment, venous/venous insufficiency]- Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) by an unknown pathogenesis. MR venography and postmortem studies have demonstrated a topographic correspondence between multiple sclerosis (MS) plaques and the cerebral venous system pathology. In recent observational studies performed on patients from distinctive gene pools, the prevalence of chronic cerebrospinal venous insufficiency ( CCSVI) in MS ranged from 56% to 100%. Endovascular treatment (percutaneous transluminal angioplasty (PTA) with or without stenting) of CCSVI was reported to be feasible with a minor complication rate. In 4 patients with different forms of multiple sclerosis venography was performed that revealed stenosis of the proximal region of the jugular vein (right or left)..[Kipshidze:2011]
[ccsvi, chronic/chronic venous, multiple sclerosis, treatment, venous/venous insufficiency]- Chronic impaired venous outflow from the central nervous system has recently been claimed to be associated with multiple sclerosis (MS) pathology. This resulted in the term chronic cerebrospinal venous insufficiency ( CCSVI) in MS. The concept of CCSVI is based on sonography studies showing that impaired venous outflow leading to pathological reflux is almost exclusively present in MS patients but not in healthy controls. Based on these findings, a new pathophysiological concept has been introduced suggesting that chronic venous outflow obstruction and venous reflux in the CNS result in pathological iron depositions leading to inflammation and neurodegeneration. The theory of CCSVI in MS has rapidly generated tremendous interest in the media and among patients and the scientific community. In particular, the potential shift in treatment concepts possibly leading to an interventional treatment approach including balloon angioplasty and venous stent placement is currently being debated. However, results from recent studies involving several imaging modalities have raised substantial concerns regarding the CCSVI concept in MS. In this review article, we explain the concept of CCSVI in MS and discuss this hypothesis in the context of MS pathophysiology and imaging studies which have tried to reproduce or refute this theory. In addition, we draw some major conclusions focusing in particular on the crucial question as to whether interventional treatment options are expedient. In conclusion, the present conclusive data confuting the theory of CCSVI in MS should lead to reluctance with respect to the interventional treatment of possible venous anomalies in MS patients..[Wattjes:2011]{Human}
[ccsvi, chronic, multiple sclerosis, therapy/treatment, venous/venous insufficiency]- Recent reports have emerged suggesting that multiple sclerosis (MS) may be due to abnormal venous outflow from the central nervous system, termed chronic cerebrospinal venous insufficiency ( CCSVI). These reports have generated strong interest and controversy over the prospect of a treatable cause of this chronic debilitating disease. This review aims to describe the proposed association between CCSVI and MS, summarize the current data, and discuss the role of endovascular therapy and the need for rigorous randomized clinical trials to evaluate this association and treatment..[Marc:2011]
[chronic, multiple sclerosis, spinal, therapy]- Multiple sclerosis is a chronic autoimmune disease affecting the central nervous system, more specifically, the myelin sheath covering of nerve fibers in the brain and spinal cord. This disease requires lifelong disease-modifying therapy, and all of the currently available first-line disease-modifying agents are parenteral formulations only..[Kristen:2010]{Human}
[ccsvi, chronic, multiple sclerosis, venous/venous insufficiency]- A chronic state of impaired venous drainage from the central nervous system, termed chronic cerebrospinal venous insufficiency ( CCSVI), is claimed to be a pathologic phenomenon exclusively seen in multiple sclerosis (MS)..[Omar:2010]{Human}
- Currently, the hypothesis that altered venous hemodynamics might play a causative role in the pathogenesis of multiple sclerosis (MS) is being controversially discussed. This new " venous hypothesis" postulates that obstructions of the cervical venous system cause an increased pressure of the intracranial venous system and that in turn intracranial congestion disintegrates the blood-brain barrier initiating the inflammatory process in MS.The " venous hypothesis" is analyzed and evaluated with regard to the following aspects: first concerning the validity of published data, second with regard to the plausibility in view of the currently approved pathogenetic model of MS, and third with regard to the compatibility with preliminary neurosonological findings in a small but unselected cohort of patients at our department.The authors conclude that the " chronic cerebrospinal venous insufficiency ( CCSVI)" cannot represent the exclusive pathogenetic factor in the pathogenesis of MS. In our cohort, only 20% of the patients fulfilled the required neurosonological features of CCSVI..[Krogias:2010]{Human}
- A new venous disorder, chronic cerebrospinal venous insufficiency ( CCSVI), has been proposed in patients with multiple sclerosis (MS). It is a vascular condition characterized by an impaired cerebrospinal venous drainage due to obstructions in the main extracranial cerebrovenous outflow routes (i.e. internal jugular veins [IJV] and/or azygos veins). In this review, the studies which assessed the prevalence of CCSVI in MS by echo colour Doppler (ECD) will be discussed. The technical aspects of determination of the five CCSVI criteria: (1) reflux in the IJV and/or vertebral veins in supine and upright position, (2) reflux in the deep cerebral veins, (3) high-resolution B-mode proximal IJV stenosis, (4) flow not Doppler detectable in IJVs and/or vertebral veins (VVs) and (5) reverted postural control of the main cerebrovenous outflow pathway are described in detail. We conclude that so far there are many studies with contradictory results, and as yet a strong scientific base to support the evidence for a causative relationship of CCSVI and MS is lacking. Recent studies call into question the validity of using ECD as a proper and reliable test for the diagnosis of CCSVI. One explanation for the variety in interpretation of the individual CCSVI criteria, with the wide-ranging percentages CCSVI, could be the different methods by using ECD to determine various criteria..[Van:2012]
- Recent work has raised the possibility that MS is not caused primarily by an immune abnormality but may instead arise from venous anomalies affecting the jugular and/or azygos venous systems. This condition has been called chronic cerebrospinal venous insufficiency ( CCSVI). It has been proposed that CCSVI may be pathogenic in MS, causing venous back pressure and iron deposition, with a secondary immune response. Some investigators have proceeded to unblinded nonrandomized angioplasty and stenting procedures in patients with CCSVI, with anecdotal reports of symptom improvement. Because of conflicting data on the presence of CCSVI and the absence of controlled trials of CCSVI intervention, the current standard of clinical care is neither to evaluate multiple sclerosis (MS) patients for CCSVI anomalies, nor to intervene with procedures to alter such anomalies. There is intense interest and ongoing work to evaluate the presence of venous anomalies in MS patients as well as in normal controls and patients with other neurologic conditions; to characterize such anomalies, if present; and to further understand whether the concept of a "backpressure" pathology is borne out by the evidence. If CCSVI is indeed a pathogenic mechanism for some subset of the MS population, this would dramatically change the focus of attention for therapeutic endeavors and monitoring for this population and would bring MS therapeutics firmly into the area of vascular intervention..[Claudiu:2012]
[chronic, multiple sclerosis, spinal]- Conversely, in chronic inflammation of the central nervous system (CNS), atrophy has previously also been described and neurodegeneration is discussed as a pathologic feature. The most frequent chronic inflammatory disease of the CNS is multiple sclerosis (MS), which leads to devastating relapsing-remitting symptoms and disability during the relapses, increasingly during the course of disease in patients. Meanwhile it became clear that axons already reveal pathology early in the disease and neurons are affected in the cortex and the spinal cord, albeit to a different extent..[Zipp:2011]{Human}
- A growing body of evidence indicates that irreversible tissue destruction including axonal and neuronal degeneration is a key component of the multiple sclerosis (MS) disease process. Magnetic resonance imaging (MRI) is a powerful technique that can be combined with semiautomated or automated computer assisted analysis approaches to detect progressive atrophy of the brain and spinal cord with high sensitivity and reproducibility. The pathophysiology of central nervous system (CNS) atrophy in MS is unknown but likely represents an epiphenomenon related to the effects of inflammation including chronic demyelination, axonal injury, neuronal loss and Wallerian degeneration..[Robert:2004]{Human}
[chronic, multiple sclerosis, treatments]- Moreover, brain hypoperfusion may lead to chronic fatigue and other global neurologic symptoms. It is hoped that this review will help to elucidate new strategies and treatments for multiple sclerosis and will show new avenues for the research on this debilitating disease..[Marian:2012]
[multiple sclerosis, therapies, treatment]- Although comparing these new drugs with available therapies is difficult, they do show promise as potential first-line agents for the treatment of multiple sclerosis. This marks a new frontier in the treatment of this disease, as the advent of new oral drugs will lead to increased patient compliance and contribute to longer sustained symptom-free periods and less marked disability..[Kristen:2010]{Human}
[multiple sclerosis, therapies, therapy/treatment]- Current medication used in MS treatment as well as medications about to be approved are primarily anti-inflammatory therapies. By modulating the immune system and thereby blocking key steps of the pathology, the immunomodulation therapies in MS have a slight impact on disability progression. There is, however, clinical and experimental data concerning the potential neuroprotective properties of novel therapies. Combining anti-inflammatory and direct neuroprotective or even neuroregenerative therapy strategies would be a step forward in the treatment of multiple sclerosis..[Zipp:2011]{Human}
[ccsvi, chronic/chronic venous, sclerosis, venous, venous insufficiency]- However, the recent description of chronic cerebrospinal venous insufficiency ( CCSVI) associated to MS, with significant anomalies in cerebral venous outflow hemodynamics, permit to propose a parallel with chronic venous disorders (CVDs) in the mechanism of iron deposition. Abnormal cerebral venous reflux is peculiar to MS, and was not found in a miscellaneous of patients affected by other neurodegenerative disorders characterized by iron stores, such as Parkinson's, Alzheimer's, amyotrophic lateral sclerosis. Several recently published studies support the hypothesis that MS progresses along the venous vasculature. The peculiarity of CCSVI-related cerebral venous blood flow disturbances, together with the histology of the perivenous spaces and recent findings from advanced magnetic resonance imaging techniques, support the hypothesis that iron deposits in MS are a consequence of altered cerebral venous return and chronic insufficient venous drainage..[Ajay:2009]{Human}
[disseminated sclerosis]- In patients with disseminated sclerosis and in a control group inhibition of granulocyte adherence was investigated after stimulation with the ionophore A23187 and the effect of autologous thrombocytes on this reactivity was investigated..[Mayer:1990]{Human}
[multiple sclerosis, therapies]- In conclusion the B cell tolerizing effect of spMBP82-98 segregated into four kinetic profiles; this molecular variability should be considered in attempts to develop specific 'peptide therapies' for the broad range of clinical profiles currently diagnosed as ' multiple sclerosis'. Multiple Sclerosis (2000) 6 300 - 311.[Warren:2000]{Human}
- Currently available disease-modifying therapies (DMTs) are known to be only partially effective in adults with multiple sclerosis (MS)..[Ann:2010]
- Multiple sclerosis is a complex inflammatory disease of the central nervous system that is variable in terms of symptoms and presentation. The objectives of this article are to review briefly the epidemiology and pathophysiology of MS and to focus on the major categories of therapies currently in use to treat MS..[Melody:2009]{Human}
[multiple sclerosis, venous]- To investigate the differences between multiple sclerosis (MS) and control subjects by using extracranial venous grey-scale, colour and spectral Doppler ultrasound..[Fatih:2011]
[ccsvi, multiple sclerosis, chronic cerebro-spinal venous insufficiency/venous]- The truncular venous malformation (VM) represents an embryologically defective vein where developmental arrest has occurred during the vascular trunk formation period in the 'later stage' of the embryonic development. A relatively simple truncular VM lesion such as a venous web at the hepatic venous outlet causes portal hypertension giving a profound damage/impact to the liver. A similar condition involving the head and neck venous system may cause chronic cerebro-spinal venous insufficiency ( CCSVI) and may be involved in the development or exacerbation of multiple sclerosis..[Lee:2010]{Human}
- Multiple sclerosis (MS) is an inflammatory demyelinating disease of the CNS caused by the interplay of genetic and environmental factors. In the last years, it has been suggested that an abnormal venous drainage due to stenosis or malformation of the internal jugular and/or azygous veins may play a major pathogenetic role in MS. This abnormality called chronic cerebro-spinal venous insufficiency ( CCSVI) could result in increased permeability of blood brain barrier, local iron deposition and secondary multifocal inflammation..[Ghezzi:2011]{Human}
[chronic, multiple sclerosis, treatment]- Azathioprine is an immunosuppressive drug widely used in the treatment of chronic inflammatory diseases, including Multiple Sclerosis (MS). We report two patients who developed the first manifestations of clinically definite multiple sclerosis while on long term (3.5 and 10 years, respectively) treatment with azathioprine for Crohn's disease..[Constantinescu:2000]{Human}
- Tumor necrosis factor (TNF) alpha, interleukins (IL) 2, 4, 6, and 10, and IgG oligoclonal bands (IgG OB) in vitro production was assessed, after whole-blood stimulation with lipopolysaccharide or concanavalin A, in 61 patients presenting with relapsing-remitting, relapsing-progressive, or chronic progressive multiple sclerosis. Multiple sclerosis patients were receiving no treatment or azathioprine (AZA), cyclosporin, cyclophosphamide, subcutaneous interferon (IFN) beta 1 a, or corticosteroids (CST)..[Schluep:2000]{Human}
[chronic, multiple sclerosis, therapy/treatment]- Although cyclophosphamide pulse therapy has been reported to be beneficial for patients with chronic progressive multiple sclerosis for whom other treatment modalities are not expected to improve outcome, the experience with Japanese patients has not been shown in the literature..[Watanabe:1993]{Human}
[chronic, multiple sclerosis]- Multiple sclerosis (MS) is a chronic neurological disease that typically affects young adults..[Yára:2011]{Human}
- We conducted a qualitative inquiry in order to describe the meaning of women's experiences of living with multiple sclerosis (MS). Multiple sclerosis is a chronic autoimmune disease of the central nervous system..[Malin:2008]{Human}
- Multiple sclerosis (MS) is an incurable neurological illness that frequently causes chronic disability..[Khan:1996]{Human}
- Multiple sclerosis (MS) is a chronic progressive disease which is the leading cause, after road traffic accidents, of handicap in young subjects..[Donz?:2007]{Human}
- MS ( multiple sclerosis) is a chronic autoimmune and neurodegenerative pathology of the CNS (central nervous system) affecting approx. 2.5 million people worldwide..[Yossan-Var:2011]
- Multiple sclerosis (MS), a chronic disease of the central nervous system, is characterized by a variable and unpredictable course..[Madonna:2000]{Human}
- A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined..[Barlow:2010]{Human}
- Multiple sclerosis (MS) is primarily an autoimmune disorder of unknown origin. This review focuses iron overload and oxidative stress as surrounding cause that leads to immunomodulation in chronic MS..[Ajay:2009]{Human}
- This focus group, qualitative study (N = 18) reports the psychosocial impact, specifically, of spasticity symptoms on a sample of people with MS ( multiple sclerosis). MS, a chronic disabling disease which attacks the central nervous system, currently affects about 100,000 people in the UK and estimates indicate that worldwide prevalence varies from around 10 to 250 per 100,000..[Nicolson:2011]
- T-cell clones derived from the CSF (cerebrospinal fluid) of MS ( multiple sclerosis) patients have been analysed for the production of interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-4 (IL-4). Each CSF-T clone (both CD4+ and CD8+) produced substantial amounts of IFN-gamma and especially TNF-alpha compared with autologous peripheral T clones and liver-infiltrating T clones from patients with chronic active hepatitis..[Buttinelli:1994]{Human}
[ccsvi, chronic, therapy/treatment, venous, venous insufficiency]- She underwent percutaneous balloon angioplasty of the associated chronic cerebrospinal venous insufficiency ( CCSVI), due to membranous obstruction of the proximal azygous vein, with severe stenosis of the left internal jugular vein. Treatment of the associated CCSVI made a parallel improvement in both clinical and neurophysiological parameters, allowing us to avoid high dose steroid therapy. The relationship between the clinical and neurophysiological course on the one hand, and haemodynamic correction of the associated CCSVI on the other, calls for further exploration on a wider number of patients. The impact of CCSVI on the different neuro-physiological parameters has not been fully estimated, but the intriguing case here reported suggests that it may be greater than previously assumed. The demonstration of a modification of the cerebrovenous function with both clinical manifestation and via TMS suggests that the hampered cerebral venous return may contribute to the clinical course of MS..[Plasmati:2010]{Human}
[multiple sclerosis, disease management/treatment]- Interferon beta-1b (Betaseron), a drug that affects the natural course of the disease, was developed for the treatment of relapsing-remitting MS. Multiple Sclerosis Pathways (MSP), a disease management program, was developed to provide comprehensive and personal support to MS patients taking interferon beta-1b and to serve as an information resource for all people with MS, their families, and healthcare professionals..[Madonna:2000]{Human}
[multiple sclerosis, treatment]- PTA seems to be an effective treatment for patients with CCVI and multiple sclerosis, However, randomized studies are warranted to establish the efficacy of this new treatment for MS..[Kipshidze:2011]
- The ionophoretic stimulation of granulocytes incubated with thrombocytes caused marked inhibition of leucocyte adherence in healthy controls and to a significantly smaller extent in patients with multiple sclerosis without corticosteroid treatment..[Mayer:1990]{Human}
- Multiple sclerosis (MS) is a disease of the white matter. Magnetic resonance imaging (MRI) is proven to be a sensitive method of monitoring the progression of this disease and of its changes due to treatment protocols. Quantification of the severity of the disease through estimation of MS lesion volume via MR imaging is vital for understanding and monitoring the disease and its treatment..[Udupa:1997]{Human}
- A twenty-five year old woman developed a progressive right hemiparesis which remitted within three months, without treatment. The diagnosis was a first relapse of multiple sclerosis..[Confavreux:1994]{Human}
[multiple sclerosis, therapy]- A disability-scoring and an EEG-spectral analysis was performed in patients suffering from clinically and biochemically (oligoclonal aspect in cerebro-spinal fluid) proven multiple sclerosis at two stages of their illness, that are before and after a short intensive immuno suppressive therapy..[Colon:1982]{Human}
[chronic, venous, venous insufficiency]- Further interest has been generated by the idea of chronic cerebrospinal venous insufficiency that might be associated with brain iron accumulation due to a reduction in venous outflow, but its existence and etiologic role in MS are currently controversially debated..[Michael:2011]
[ccsvi, multiple sclerosis]- Currently, there is inconclusive evidence to support CCSVI as an etiological factor in patients with multiple sclerosis..[Amer:2011]
[chronic, multiple/multiple sclerosis, sclerosis, spinal]- The analysis of clinical neurological symptoms on the basis of available letters and other documents confirms beyond a doubt the long standing diagnosis of neurosyphilis in the form of chronic meningitis with cranial polyneuritis and wide spread polyradiculitis, formerly called Lues cerebro-spinalis. The symptoms which recurred over 25 years include multiple severe paralysis of cranial nerves, dramatic radicular neuralgias and radicular paralysis in addition to a partial transverse lesion of the spinal cord and terminal coughing and regurgation fits in the absence of symptoms in the cerebrum and brain stem, these symptoms hardly permit different diagnosis. Tuberculosis, lead poisoning, multiple sclerosis or even a myatrophic lateral sclerosis do not explain his neurological symptoms or the cause of his death..[Schiffter:2005]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
[cerebro spinal]- The authors present a new technique for the analysis of the cerebro spinal fluid (C.S.F.) proteins: silver stain after isoelectric focusing with possibility of immunofixation..[Confavreux:1982]{Human}
[ccsvi, chronic, venous insufficiency]- The condition was named chronic cerebrospinal venous insufficiency ( CCSVI)..[Yára:2011]{Human}
- The presence of chronic cerebrospinal venous insufficiency ( CCSVI) was defined according to previously reported criteria for the extracranial and transcranial US techniques..[Marcello:2012]
[chronic, therapies, venous]- The hypothesis proposes mechanisms by which an infective venous vasculitis could result in the specific neural damage, metabolic, immunological and vascular effects observed in MS. The hypothesis described is consistent with many of the known facts of MS pathogenesis and therefore provides a framework for further research into a venous aetiology for the disease.If MS does result from a chronic infective venulitis rather than a syndrome involving congenital truncular venous malformations, then additional therapies to the currently used angioplasties will be required to optimize results..[Thibault:2012]
[multiple sclerosis/numerous, sclerosis, spinal]- Minocycline, a commonly prescribed tetracycline antibiotic, has shown promise as a potential therapeutic agent in animal models of numerous neurologic disorders such as amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, Huntington's disease, stroke, and spinal cord injury (SCI)..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
[insufficiency, spinal, treatment]- The medical situations associated with an increased risk of thrombosis which are well documented are cancer, myocardial infarction, cardiac insufficiency, ischemic cerebro-vascular accidents with paralysis of lower limb(s), acute respiratory insufficiency in patients admitted to intensive care unit, prolonged immobilisation in elderly invalid patients and paralysis of the limbs due to spinal trauma. Prophylactic treatment in medical patients is still empirical..[Samama:1996]{Human}
[therapies, treatment, treatments]- Atrophy should now be included as a secondary endpoint in trials of therapies aimed at limiting disease progression. Currently available anti-inflammatory immunomodulatory agents and immunosuppressive treatments, while effective at preventing clinical deterioration, have shown at best partial effects in preventing CNS atrophy. Thus, there is a need to further validate atrophy as an outcome measure and ultimately develop treatment strategies that will protect against the destructive aspects of the disease process..[Robert:2004]{Human}
[lay, multiple sclerosis/sclerosis]- Although frequently suggested in the lay press, there is no proven effect in other indications, such as amyotrophic lateral sclerosis, multiple sclerosis and myocardial infarction..[Braat:2006]{Human}
[lay, treatments]- In the future, rehabilitation professionals will have to learn how to anticipate patient needs and lay the groundwork for services and equipment in advance. Rehabilitation is one of the treatments of MS patients and should be viewed as an ongoing process to maintain and restore maximum function and quality of life..[Donz?:2007]{Human}
[multiple sclerosis, spinal]- A new sign of multiple sclerosis, the contracting cord sign, is described. The myelographic demonstration of a large cord that subsequently decreases in size may suggest multiple sclerosis. Multiple sclerosis must be considered in the differential diagnosis of an enlarged spinal cord..[Haughton:1979]{Human}
- The myelinotoxicity of sera from multiple sclerosis (MS) patients was determined by the assessment of visible myelin damage in guinea-pig spinal cord-spinal ganglia and in rat cerebella cultivated on collagen-coated coverslips in Leighton tubes..[Hauw:1987]{Human}
[multiple sclerosis, cerebro spinal/spinal]- This study is in agreement with the other series reported from Asia regarding the special clinical features of multiple sclerosis described from this part of the world. There is more common occurrence of visual impairment at onset, predominant involvement of optic nerves and spinal cord and higher incidence of classical neuromyelitis optica. There is no relationship of any or all cerebro spinal fluid abnormalities with the type of multiple sclerosis, duration of an attack and disability, except for the possible relation between the type of colloidal gold reaction pattern and the type of multiple sclerosis..[Chopra:1981]{Human}
[insular sclerosis, spinal]- Newman, a young physician returning from Aberdeen University, made first mention of MS in the Australian literature when he gave a dissertation entitled 'On insular sclerosis of the brain and spinal cord' which was based on Charcot's teachings..[Frith:1989]{Human}
[multiple sclerosis/sclerosis, spinal]- The autopsy showed characteristic "old" plaques of multiple sclerosis in the cerebrum with anterior horn cell and pyramidal tracts degeneration, typical of amyotrophic lateral sclerosis, in the spinal cord. Although exceptional, this association of amyotrophic lateral sclerosis and multiple sclerosis leads to the discussion of an etiological immunological dysregulation common to these two diseases..[Confavreux:1994]{Human}
- Cerebrospinal fluid analysis was consistent with multiple sclerosis. The patient died of respiratory failure two years after presentation, and autopsy revealed multifocal demyelination involving the corpus callosum, cerebellum and spinal cord as well as pathologic findings typical of amyotrophic lateral sclerosis. A review of the literature confirms the exceedingly unusual combination of amyotrophic lateral sclerosis with multiple sclerosis..[Dynes:2001]{Human}
[multiple, treatment, venous]- TMS supports the diagnosis of MS, detecting corticospinal tract involvement and monitoring its course with or without treatment. It has been never investigated whether any relationship exists between the TMS outcome measure and minimally invasive treatment of multiple severe extracranial stenosis, affecting the principal ce rebrospinal venous segments in MS patients..[Plasmati:2010]{Human}
[spinal, treatments]- Spinal cord MRI may provide information about disease progression that is not readily available from brain MRI scans and could be useful in diagnosing MS in some cases, as well as for monitoring the effects of treatments..[Christopher:2005]{Human}
[ccsvi, chronic, venous/venous insufficiency]- Third, the pathology of MS might be the consequence of a chronic state of impaired venous drainage from the CNS, for which the term chronic cerebrospinal venous insufficiency ( CCSVI) has been coined. A number of recent vascular studies do not support the CCSVI theory, but some elements of CCSVI might be explained by slower cerebral venous blood flow secondary to the reduced cerebral perfusion in patients with MS compared with healthy individuals..[Miguel:2011]{Human}
[therapies, treatment]- Emerging therapies are rapidly expanding treatment options, including both parenterally administered and oral medications..[Daniel:2012]
[therapies, disease management/therapy/treatments]- Overall, 144 children (55.8%) continued receiving 1 therapy, while 65 (25.2%), 29 (11.2%), and 20 (7.8%) received 2, 3, or 4 or more sequential therapies, respectively, during a mean (SD) observation period of 3.9 (2.8) years. Second-line DMT use was restricted to interferon beta and glatiramer acetate in 203 children (78.7%), whereas other treatments such as broad-spectrum chemotherapies (cyclophosphamide, mitoxantrone hydrochloride), natalizumab, corticosteroids (monthly), and daclizumab were used at some point during the observation period for disease management in 55 children (21.3%)..[Ann:2010]
[treatment, venous]- A potential shift in the treatment paradigm of MS involving endovascular balloon angioplasty or venous stent placement has been proposed as well as conducted in small patient series..[Omar:2010]{Human}
[ccsvi, treatment, venous]- Clinicians should be aware that endovenous treatment of CCSVI could cause paradoxical deterioration of cerebral venous drainage..[null:2011]{Human}
- The pathophysiology of CCSVI is yet to be defined. The superior cava venous system is highly complex in terms of anatomy and possible anomalies, as well as its haemodynamic mechanisms. Further studies are required to define the parameters of diagnosis and treatment of CCSVI..[Lugli:2012]
[spinal, treatment]- The corticospinal and rubrospinal tracts were traced and the spinal cords were harvested 7 weeks after injury. The extent of gray matter and white matter sparing and corticospinal and rubrospinal tract sprouting were evaluated in cross sections of the spinal cord. In the end, neither minocycline nor simvastatin treatment was associated with improved performance on the behavioral tests, as compared to saline controls..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
[multiple sclerosis]- The pyramidal pathway is frequently affected early on in multiple sclerosis (MS) and impaired motor performance is a major cause of disability..[Plasmati:2010]{Human}
- Three types of vascular dysfunction have been described in multiple sclerosis (MS)..[Miguel:2011]{Human}
- OPINION Multiple sclerosis (MS) is a relapsing and progressive disorder of the central nervous system..[Claudiu:2012]
- Fifty-four patients, with multiple sclerosis from North-West India are described. This included two pathologically proven cases of multiple sclerosis..[Chopra:1981]{Human}
- The diagnostic value of CSF oligoclonal IgG bands, intrathecal IgG synthesis, cytology and markers of myelin breakdown in the cerebro-spinal fluid were evaluated in multiple sclerosis..[Schmidt:1987]{Human}
- Multiple Sclerosis (2000) 6 362 - 363.[Constantinescu:2000]{Human}
- The presence of IL-2 receptor and HLA class II antigens as detected by monoclonal antibodies on mononuclear cells from both cerebro-spinal fluid (CSF) and peripheral blood was examined by cytofluorographic analysis in patients with multiple sclerosis (MS) and other neurological diseases..[Tournier-Lasserve:1987]{Human}
- The aim of this study was to simultaneously measure in vivo volumes of gray matter (GM), normal white matter (WM), abnormal white matter (aWM), and cerebro-spinal fluid (CSF), and to assess their relationship in 50 patients with relapsing-remitting multiple sclerosis (RR-MS) (age range, 21-59; mean EDSS, 2.5; mean disease duration, 9.9 years), using an unsupervised multiparametric segmentation procedure applied to brain MR studies..[Mario:2003]{Human}
- Purpose: To assess cerebral circulation times (CCTs) in patients with multiple sclerosis (MS) and control subjects by using contrast material-enhanced ultrasonography (US) to determine whether vascular abnormalities can be detected in this disease..[Marcello:2012]
- The present paper is based on an exact analysis of the neurootological findings in 30 cases of multiple sclerosis (MS)..[Meran:1977]{Human}
- In 1868 Jean-Martin Charcot's clinicopathological correlation of multiple sclerosis (MS) was published..[Frith:1989]{Human}
- HTLV-1 in endemic in populations which are recognized as having low risk of multiple sclerosis . Multiple sclerosis generally evolves as a relapsing-remitting disease and affects predominantly Caucasians..[Jo?l:2007]{Human}
- The results suggest a change of membrane properties, dependent on thrombocytes, in the early stage of non-specific granulocyte activation in patients with multiple sclerosis..[Mayer:1990]{Human}
- Multiple Sclerosis (2000) 6, 66 - 68.[Hay:2000]{Human}
- The study aimed to evaluate neopterin levels in cerebro-spinal fluid (CSF) as a marker of disease activation and progression of multiple sclerosis (MS)..[Tsolaki:2003]
- CD154 (CD40-ligand, gp39), expressed on activated T cells, is crucial in T cell-dependent immune responses and may be involved in the pathogenesis of multiple sclerosis (MS)..[Jensen:2001]{Human}
- Multiple sclerosis fatigue was unrelated to either depression or global impairment. Multiple sclerosis fatigue appears to be a distinct clinical entity, often disabling, that can be distinguished from normal fatigue, affective disturbance, and neurologic impairment..[Krupp:1988]{Human}
- Increased iron deposition might be implicated in multiple sclerosis (MS)..[Michael:2011]
- Although the association of a clinical picture resembling multiple sclerosis with ankylosing spondylitis has been reported, there are a few, and sometimes poorly documented, published cases..[Garc?a:1980]{Human}
- The first autopsy of a case of multiple sclerosis from the District of Hokuriku was reported..[Isaki:1980]{Human}
- Lymphocytes subpopulations in cerebro-spinal fluid (CSF) and peripheral blood (PB) from multiple sclerosis (MS) patients were studied..[Manconi:1981]{Human}
- Late onset multiple sclerosis (LOMS), defined as the first presentation of clinical symptoms in patients over 50, is not a rare phenomenon as previously thought, since the prevalence ranges between 4% and 9.6% in different studies..[Martinelli:2005]{Human}
- No distribution of these bands, particularly in the more cathodal zone, seems to be specific of any disease including multiple sclerosis (M.S.)..[Confavreux:1982]{Human}
- Fatigue is a frequent symptom in multiple sclerosis (MS) that can interfere with a patient's daily functioning..[Krupp:1988]{Human}
- In conclusion, we found no evidence confirming the suggested vascular multiple sclerosis hypothesis..[Peter:2010]{Human}
- Detection frequency of human herpesvirus 6 (HHV-6) and Epstein Barr virus (EBV) DNA in multiple sclerosis (MS) patients and controls was investigated..[Hay:2000]{Human}
- A case of transitional type of multiple sclerosis with large periventricular cuffs of demyelination is presented..[Pruchnik:1994]{Human}
- Circulating immune complexes were looked for on 38 clinically definite MS ( multiple sclerosis) patients compared to 35 other neurological patients and 26 healthy subjects. 29% of the MS sera and 8.6% of the other neurological sera were positive, whereas none of the control sera were positive..[Davous:1978]{Human}
- LOMS is usually associated with a faster progression to disability compared to young adult multiple sclerosis (MS) patients..[Martinelli:2005]{Human}
- Multiple sclerosis [MS], a demyelinating disease of the central nervous system associated with inflammation and gliosis, may be an autoimmune disease with T lymphocytes and autoantibodies to myelin protein(s)..[Warren:2000]{Human}
[multiple sclerosis/sclerosis]- Neutral protease activity was significantly elevated in the cerebro-spinal fluid of patients with multiple sclerosis (MS) in exacerbation and in the acute phase of acute viral meningoencephalitis (AME) compared with that of MS in remission, amyotrophic lateral sclerosis or psychosomatic disease..[Inuzuka:1987]{Human}
[venous]- These findings may support the venous occlusion theory, but may also be explained by atrophy-dependent ventricular dilatation independent of the venous theory in MS patients..[Gorucu:2012]
- The prevention of post-operative venous thromboembolic accidents is well documented..[Samama:1996]{Human}
- Ultrasonography after the procedure is recommended to confirm venous patency and to identify patients experiencing acute venous thrombosis..[Kenneth:2012]
[spinal]- Pathologically, MS is associated with focal areas of myelin destruction, inflammation, and axonal transection ("demyelinating plaques") in the brain and spinal cord..[Claudiu:2012]
- Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy..[Renzo:2011]
- Secondly, it may result in significant hypoperfusion of the brain and spinal cord..[Marian:2012]
- In Asians MS affects preferentially the spinal cord..[Jo?l:2007]{Human}
- Histopathologically, there were many recent and old demyelinating lesions of varying sizes and shapes in all parts of the central nervous system, namely the cerebrum, brainstem, spinal cord and optic nerve..[Isaki:1980]{Human}
- Despite the technical difficulties of performing spinal cord MRI, imaging studies, particularly of the cervical cord, are becoming more common..[Christopher:2005]{Human}
- As both drugs have translational potential, we evaluated their neuroprotective properties here in a clinically relevant model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- In conclusion, both minocycline and simvastatin failed to improve functional and histological recovery in our model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
[multiple sclerosis/sclerosis]- Conclusions: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis..[Renzo:2011]
- Two of them presented with concomitant, relatively rare disabling neurological diseases, namely amyotrophic lateral sclerosis and multiple sclerosis..[Renzo:2011]
[sclerosis]- Loss of neurons due to cell death and axonal degeneration characterize neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease or amyotrophic lateral sclerosis..[Zipp:2011]{Human}
[ccsvi, venous]- To the contrary, substitute circles are alternative pathways or vicarious venous shunts, which permit the drainage and prevent intracranial hypertension. In accordance with the pattern of obstruction, even the intracranial and the intrarachidian veins can also become substitute circles; they permit redirection of the deviated flow, piping the blood toward available venous segments outside the central nervous system. We review the complex gross and radiological anatomy of collateral circulation found activated by the means of EchoColor-Doppler and selective venography in the event of CCSVI, focusing particularly on the suboccipital cavernous sinus (SCS), the condylar venous system, the pterygoid plexus, the thyroid veins, and the emiazygous-lumbar venous anastomosis with the left renal vein..[Paolo:2009]{Human}
- This study demonstrates that venous outflow disturbances in the form of CCSVI significantly impact on CSF pathophysiology in patients with MS..[Zamboni:2009]{Human}
- Extra- and intracranial venous flow direction was assessed by colour-coded duplex sonography, and extracranial venous cross-sectional area (VCSA) of the internal jugular and vertebral veins (IJV/VV) was measured in B-mode to assess the five previously proposed CCSVI criteria..[Christoph:2011]
- Other disorders such as bilateral internal and external jugular venous ligation or radical neck dissection, which result in venous stasis, are not known causes of demyelination in the central nervous system. Our data also does not support the hypothesis of CCSVI theory, despite the fact that our study was limited to a small group of patients and the examination was performed only using Doppler ultrasound..[Masami:2011]{Human}
[ccsvi, multiple venous/venous]- CDMS is strongly associated with CCSVI, a scenario that has not previously been described, characterised by abnormal venous haemodynamics determined by extracranial multiple venous strictures of unknown origin. The location of venous obstructions plays a key role in determining the clinical course of the disease..[Zamboni:2009]{Human}
[chronic]- The purpose of this Phase I open label clinical study was to monitor CSF anti-MBP in patients with chronic progressive MS subsequent to IV administration of synthetic peptide (sp) MBP82-98 namely DEN(85)VVHFFKNIVTP(96)RT..[Warren:2000]{Human}
- Objective: Herein, we report 3 cases of SCH and suggest a possible association with trauma-related neurodegenerative or chronic inflammatory diseases..[Renzo:2011]
- Electromyography demonstrated widespread active and chronic motor axon loss..[Dynes:2001]{Human}
[ccsvi, chronic]- This study also revealed a correlation between the occurrence of inverted flow in patients in a sitting position and chronic progressive MS (P = 0.0033). The examinations undertaken indicate a possible connection between MS and CCSVI. The widely accessible and highly sensitive and specific Doppler ultrasound test may be useful for revealing, and preliminary analysis of, CCSVI pathologies..[Zaniewski:2012]
[multiple/name multiple sclerosis/sclerosis]- The name multiple sclerosis (MS) refers to 2 features of the disease: multiple describes the number of central nervous system lesions and sclerosis refers to the demyelinated nature of the lesions..[Melody:2009]{Human}
[treatment]- The treatment is called "liberation treatment," and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment..[Reekers:2011]
- In conclusion, we can state that the result of endovascular treatment seems to decay although the baseline is still higher than preoperative..[Beelen:2012]
- In 1993, Food and Drug Administration (FDA) approved Betaseron for the treatment of MS. Todate, this is the only drug approved by the FDA, specifically for the treatment of MS..[Khan:1996]{Human}
- Our main conclusion is that, given the results we currently have available, we should be cautious and, for the time being, it would be advisable not to recommend the systematic use of this treatment for our patients..[Carmen:2011]
- Although our study of the dynamics of TNF-alpha, IL-2, IL-4, IL-6, and IL-10 in vitro production generally found no statistically significant correlations (partly explained by the limited number of values in the various groups), IL-6 was shown to drop during the periods surrounding relapse (P = 0.05) in the absence of treatment, while TNF-alpha (P = 0.04) and IL-6 (P < 0.05) dropped before exacerbation in the presence of AZA..[Schluep:2000]{Human}
- The most common application of cord blood is in the treatment of (malignant) blood disorders..[Braat:2006]{Human}
- Clinical status was analysed as regards the age at onset, the duration and course of the disease, the disability of the patients and the treatment they received..[Davous:1978]{Human}
- Since that time Australians have made an ever-increasing contribution to the world literature regarding MS pathogenesis, epidemiology and treatment..[Frith:1989]{Human}
- Many reports have been published on these different treatment options, but rarely has a comparison been made between them..[von:2001]{Human}
[therapeutic interventions/treatment]- Although switching between first-line DMTs may be effective in pediatric patients with disease that is refractory to initial treatment, a subset of patients may require second-line therapeutic interventions..[Ann:2010]
[therapy]- Significant improvement in the clinical state of the patient and a marked increase of the mean alpha frequency in the parietooccipital region could be demonstrated after short intensive immunosuppressive therapy..[Colon:1982]{Human}
- All the patients tolerated the therapy well..[Watanabe:1993]{Human}
- The positive impact of education and support on adherence to therapy has been validated by training and nurse hotline data..[Madonna:2000]{Human}
- These 3 cases have shown neurological improvements or at least arrest of the progression following the therapy..[Watanabe:1993]{Human}
[ccsvi, treatment]- The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed..[Jacek:2011]{Human}
- However, over the same nineteen-month period, the internet discussion on the subject of CCSVI and MS has led to countless websites advertising treatment using vascular surgery for patients with MS all over the world. The treatment based on the CCSVI theory has appealingly been called "liberation treatment", thus making it difficult to explain to patients why a treatment that has been highly praised (on the internet) cannot be recommended based on partial medical results that await confirmation..[Yára:2011]{Human}
- In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence..[Reekers:2011]
- The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment..[Reekers:2011]
- Endovascular treatment of CCSVI is a safe procedure; there is a 1.6% risk of major complications..[Kenneth:2012]
[ccsvi, therapy]- Several scientific endeavors examining the presence of CCSVI in MS are being undertaken. At present, invasive and potentially dangerous endovascular procedures as therapy for patients with MS should be discouraged until such studies have been completed, analyzed, and debated in the scientific arena..[Omar:2010]{Human}
[ccsvi]- A great variability of CCSVI has been found in both MS patients (ranging from 0 to 100%) and in control subjects (from 0 to 23%). This large variability is explained by methodological aspects, problems in assessing CCSVI, and differences among clinical series. It is urgent to perform appropriate epidemiological studies to define the possible relationship between CCSVI and MS..[Ghezzi:2011]{Human}
- Only one healthy control and no MS patients fulfilled at least two criteria for CCSVI. Conclusions This triple-blinded extra- and transcranial duplex sonographic assessment of cervical and cerebral veins does not provide supportive evidence for the presence of CCSVI in MS patients. The findings cast serious doubt on the concept of CCSVI in MS..[Christoph:2011]
- All participants underwent ultrasonography (US) to detect signs of CCSVI. CCSVI was detected in 55% of patients in the MS group and 35% in the control group; the difference was not statistically significant (p=0.089). In our experience, a slight difference exists in the prevalence of CCSVI between MS and healthy controls, but it is not as yet clear which parameters may be most significant. This preliminary study failed to show a statistically significant difference in the prevalence of CCSVI among patients affected by MS..[Floris:2012]
- Ultrasound in the form of duplex scanning uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results..[Nicolaides:2012]
- This study suggests that a multimodal non-invasive approach (DS and MRV) increases the specificity for a diagnosis of CCSVI in patients with MS..[Dolic:2012]
- In this Point of View, we discuss the recent investigations that led to the description of CCSVI as well as the conceptual and technical shortcomings that challenge the potential relationship of this phenomenon to MS..[Omar:2010]{Human}
- The prevalence of CCSVI was higher in patients with MS than in control subjects (77% vs 28%, P < .0001). CCT was not significantly different between patients with MS who had CCSVI and patients with MS who did not (P = .182)..[Marcello:2012]
- Nineteen months after the original publication on CCSVI and MS, another 22 papers have been published addressing the matter..[Yára:2011]{Human}
- Further studies are required to verify these observations and to clarify if CCT and CCSVI have any physiologic and clinical relevance in MS. © RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11111239/-/DC1..[Marcello:2012]
|
| - The truncular venous malformation (VM) represents an embryologically defective vein where developmental arrest has occurred during the vascular trunk formation period in the 'later stage' of the embryonic development. A relatively simple truncular VM lesion such as a venous web at the hepatic venous outlet causes portal hypertension giving a profound damage/impact to the liver. A similar condition involving the head and neck venous system may cause chronic cerebro-spinal venous insufficiency ( CCSVI) and may be involved in the development or exacerbation of multiple sclerosis..[Lee:2010]{Human}
- She underwent percutaneous balloon angioplasty of the associated chronic cerebrospinal venous insufficiency ( CCSVI), due to membranous obstruction of the proximal azygous vein, with severe stenosis of the left internal jugular vein. Treatment of the associated CCSVI made a parallel improvement in both clinical and neurophysiological parameters, allowing us to avoid high dose steroid therapy. The relationship between the clinical and neurophysiological course on the one hand, and haemodynamic correction of the associated CCSVI on the other, calls for further exploration on a wider number of patients. The impact of CCSVI on the different neuro-physiological parameters has not been fully estimated, but the intriguing case here reported suggests that it may be greater than previously assumed. The demonstration of a modification of the cerebrovenous function with both clinical manifestation and via TMS suggests that the hampered cerebral venous return may contribute to the clinical course of MS..[Plasmati:2010]{Human}
- Multiple sclerosis (MS) is an inflammatory demyelinating disease of the CNS caused by the interplay of genetic and environmental factors. In the last years, it has been suggested that an abnormal venous drainage due to stenosis or malformation of the internal jugular and/or azygous veins may play a major pathogenetic role in MS. This abnormality called chronic cerebro-spinal venous insufficiency ( CCSVI) could result in increased permeability of blood brain barrier, local iron deposition and secondary multifocal inflammation..[Ghezzi:2011]{Human}
- TMS supports the diagnosis of MS, detecting corticospinal tract involvement and monitoring its course with or without treatment. It has been never investigated whether any relationship exists between the TMS outcome measure and minimally invasive treatment of multiple severe extracranial stenosis, affecting the principal ce rebrospinal venous segments in MS patients..[Plasmati:2010]{Human}
- The Chronic Cerebro-Spinal Venous Insufficiency, recently described as a possible role in Multiple Sclerosis pathogenesis, is diagnosed and classified with Echo Color Doppler (ECD) examination of the extra- and intra-cranial veins..[Maria:2012]
- A chronic state of impaired venous drainage from the central nervous system, termed chronic cerebrospinal venous insufficiency ( CCSVI), is claimed to be a pathologic phenomenon exclusively seen in multiple sclerosis (MS)..[Omar:2010]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) was recently described in multiple sclerosis patients. CCSVI is characterized by impaired brain venous drainage due to outflow obstruction in the extracranial venous system, mostly related to anomalies in the internal jugular and azygos veins. The current CCSVI diagnosis is based on Doppler sonography of extracranial and transcranial venous hemodynamics criteria. To date, prevalence estimates of CCSVI, provided by different groups using various imaging methods of assessment, vary widely from none to 100%. There is an urgent need to define and validate the spectrum of cranial/extracranial venous anomalies and to establish reliable, diagnostic gold-standard test(s). The potential usefulness of endovascular treatment for CCSVI in multiple sclerosis patients is still unknown..[Robert:2011]{Human}
- A great variability of CCSVI has been found in both MS patients (ranging from 0 to 100%) and in control subjects (from 0 to 23%). This large variability is explained by methodological aspects, problems in assessing CCSVI, and differences among clinical series. It is urgent to perform appropriate epidemiological studies to define the possible relationship between CCSVI and MS..[Ghezzi:2011]{Human}
- Currently, the hypothesis that altered venous hemodynamics might play a causative role in the pathogenesis of multiple sclerosis (MS) is being controversially discussed. This new " venous hypothesis" postulates that obstructions of the cervical venous system cause an increased pressure of the intracranial venous system and that in turn intracranial congestion disintegrates the blood-brain barrier initiating the inflammatory process in MS.The " venous hypothesis" is analyzed and evaluated with regard to the following aspects: first concerning the validity of published data, second with regard to the plausibility in view of the currently approved pathogenetic model of MS, and third with regard to the compatibility with preliminary neurosonological findings in a small but unselected cohort of patients at our department.The authors conclude that the " chronic cerebrospinal venous insufficiency ( CCSVI)" cannot represent the exclusive pathogenetic factor in the pathogenesis of MS. In our cohort, only 20% of the patients fulfilled the required neurosonological features of CCSVI..[Krogias:2010]{Human}
- Chronic impaired venous outflow from the central nervous system has recently been claimed to be associated with multiple sclerosis (MS) pathology. This resulted in the term chronic cerebrospinal venous insufficiency ( CCSVI) in MS. The concept of CCSVI is based on sonography studies showing that impaired venous outflow leading to pathological reflux is almost exclusively present in MS patients but not in healthy controls. Based on these findings, a new pathophysiological concept has been introduced suggesting that chronic venous outflow obstruction and venous reflux in the CNS result in pathological iron depositions leading to inflammation and neurodegeneration. The theory of CCSVI in MS has rapidly generated tremendous interest in the media and among patients and the scientific community. In particular, the potential shift in treatment concepts possibly leading to an interventional treatment approach including balloon angioplasty and venous stent placement is currently being debated. However, results from recent studies involving several imaging modalities have raised substantial concerns regarding the CCSVI concept in MS. In this review article, we explain the concept of CCSVI in MS and discuss this hypothesis in the context of MS pathophysiology and imaging studies which have tried to reproduce or refute this theory. In addition, we draw some major conclusions focusing in particular on the crucial question as to whether interventional treatment options are expedient. In conclusion, the present conclusive data confuting the theory of CCSVI in MS should lead to reluctance with respect to the interventional treatment of possible venous anomalies in MS patients..[Wattjes:2011]{Human}
- The aetiology proposed for the development of chronic cerebrospinal venous insufficiency ( CCSVI) associated with multiple sclerosis (MS) has been the presence of congenital truncular venous malformations. However, this hypothesis is not consistent with the epidemiology or geographical incidence of MS and is not consistent with many of the ultrasonographic or radiographical findings of the venous disturbances found in MS patients. However, the probability of a venous aetiology of MS remains strong based on evidence accumulated from the time the disorder was first described.The method used in this review was to search PubMed for all past medical publications related to vascular, venous, haematological, epidemiological, biochemical, and genetic investigations and treatments of MS.Epidemiological and geographical findings of prevalence of MS indicate the involvement of an infective agent. This review of the venous pathology associated with MS describes a hypothesis that the pathogenesis of the venous disease could be initiated by a respiratory infective agent such as Chlamydophila pneumonia, which causes a specific chronic persistent venulitis affecting the cerebrospinal venous system..[Thibault:2012]
- The aim of this study was to investigate whether a combination of Doppler sonography (DS) and magnetic resonance venography (MRV) on 3T MRI increases specificity for detection of chronic cerebrospinal venous insufficiency ( CCSVI) in 171 (113 relapsing-remitting, 47 secondary-progressive, 11 primary progressive) patients with multiple sclerosis (MS) and 79 age- and sexmatched healthy controls (HCs). One hundred ten (64.3%) MS patients and 30 (38%) HCs presented ≥2 venous hemodynamic CCSVI criteria (p<.0001). Both DS and MRV showed relatively high specificity but lower sensitivity for determining a CCSVI diagnosis in patients with MS vs HCs and between MS subgroups..[Dolic:2012]
- However, the recent description of chronic cerebrospinal venous insufficiency ( CCSVI) associated to MS, with significant anomalies in cerebral venous outflow hemodynamics, permit to propose a parallel with chronic venous disorders (CVDs) in the mechanism of iron deposition. Abnormal cerebral venous reflux is peculiar to MS, and was not found in a miscellaneous of patients affected by other neurodegenerative disorders characterized by iron stores, such as Parkinson's, Alzheimer's, amyotrophic lateral sclerosis. Several recently published studies support the hypothesis that MS progresses along the venous vasculature. The peculiarity of CCSVI-related cerebral venous blood flow disturbances, together with the histology of the perivenous spaces and recent findings from advanced magnetic resonance imaging techniques, support the hypothesis that iron deposits in MS are a consequence of altered cerebral venous return and chronic insufficient venous drainage..[Ajay:2009]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a vascular picture that shows a strong association with multiple sclerosis (MS). The aim of this study was to investigate the relationship between a Doppler cerebral venous hemodynamic insufficiency severity score (VHISS) and cerebrospinal fluid (CSF) flow dynamics in 16 patients presenting with CCSVI and relapsing-remitting MS (CCSVI-MS) and in eight healthy controls (HCs)..[Zamboni:2009]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome recently described in multiple sclerosis patients. It is characterized by abnormal venous hemodynamics resulting from numerous obstacles in the main veins draining the central nervous system, usually: the internal jugular veins and the azygous vein..[Ma'moon:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Ultrasound and venographic studies of the internal jugular and azygos venous systems in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 71%, range 0-100%; n=1336) associated with activation of collaterals..[Nicolaides:2012]
- A new venous disorder, chronic cerebrospinal venous insufficiency ( CCSVI), has been proposed in patients with multiple sclerosis (MS). It is a vascular condition characterized by an impaired cerebrospinal venous drainage due to obstructions in the main extracranial cerebrovenous outflow routes (i.e. internal jugular veins [IJV] and/or azygos veins). In this review, the studies which assessed the prevalence of CCSVI in MS by echo colour Doppler (ECD) will be discussed. The technical aspects of determination of the five CCSVI criteria: (1) reflux in the IJV and/or vertebral veins in supine and upright position, (2) reflux in the deep cerebral veins, (3) high-resolution B-mode proximal IJV stenosis, (4) flow not Doppler detectable in IJVs and/or vertebral veins (VVs) and (5) reverted postural control of the main cerebrovenous outflow pathway are described in detail. We conclude that so far there are many studies with contradictory results, and as yet a strong scientific base to support the evidence for a causative relationship of CCSVI and MS is lacking. Recent studies call into question the validity of using ECD as a proper and reliable test for the diagnosis of CCSVI. One explanation for the variety in interpretation of the individual CCSVI criteria, with the wide-ranging percentages CCSVI, could be the different methods by using ECD to determine various criteria..[Van:2012]
- This study aimed to evaluate the prevalence of chronic cerebrospinal venous insufficiency ( CCSVI) in patients with multiple sclerosis (MS)..[Floris:2012]
- Recent reports have emerged suggesting that multiple sclerosis (MS) may be due to abnormal venous outflow from the central nervous system, termed chronic cerebrospinal venous insufficiency ( CCSVI). These reports have generated strong interest and controversy over the prospect of a treatable cause of this chronic debilitating disease. This review aims to describe the proposed association between CCSVI and MS, summarize the current data, and discuss the role of endovascular therapy and the need for rigorous randomized clinical trials to evaluate this association and treatment..[Marc:2011]
- Third, the pathology of MS might be the consequence of a chronic state of impaired venous drainage from the CNS, for which the term chronic cerebrospinal venous insufficiency ( CCSVI) has been coined. A number of recent vascular studies do not support the CCSVI theory, but some elements of CCSVI might be explained by slower cerebral venous blood flow secondary to the reduced cerebral perfusion in patients with MS compared with healthy individuals..[Miguel:2011]{Human}
- Recent work has raised the possibility that MS is not caused primarily by an immune abnormality but may instead arise from venous anomalies affecting the jugular and/or azygos venous systems. This condition has been called chronic cerebrospinal venous insufficiency ( CCSVI). It has been proposed that CCSVI may be pathogenic in MS, causing venous back pressure and iron deposition, with a secondary immune response. Some investigators have proceeded to unblinded nonrandomized angioplasty and stenting procedures in patients with CCSVI, with anecdotal reports of symptom improvement. Because of conflicting data on the presence of CCSVI and the absence of controlled trials of CCSVI intervention, the current standard of clinical care is neither to evaluate multiple sclerosis (MS) patients for CCSVI anomalies, nor to intervene with procedures to alter such anomalies. There is intense interest and ongoing work to evaluate the presence of venous anomalies in MS patients as well as in normal controls and patients with other neurologic conditions; to characterize such anomalies, if present; and to further understand whether the concept of a "backpressure" pathology is borne out by the evidence. If CCSVI is indeed a pathogenic mechanism for some subset of the MS population, this would dramatically change the focus of attention for therapeutic endeavors and monitoring for this population and would bring MS therapeutics firmly into the area of vascular intervention..[Claudiu:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a hypothesis through which cerebral venous drainage abnormalities contribute towards the pathogenesis of multiple sclerosis. CCSVI venoplasty is already practised worldwide. We report the case of a 33-year-old lady with multiple sclerosis who underwent left internal jugular venoplasty resulting in iatrogenic jugular thrombosis requiring open thrombectomy for symptom relief..[null:2011]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) was recently proposed as a contributing factor in the pathology of multiple sclerosis. This concept has gained remarkable attention, partly because endovascular neurointervention has been suggested as a treatment strategy..[Amer:2011]
- Multiple sclerosis (MS) is a chronic disease of the central nervous system with not yet completely understood pathogenesis. The so called " chronic cerebrospinal venous insufficiency ( CCSVI) theory" has recently emerged, supporting the concept of a cerebrospinal venous drainage impairment as the cause of MS. Since the first publication on this topic with a claimed 100% specificity and sensitivity of the condition for MS diagnosis, CCSVI theory has generated a scientific and mass media debate with a great hope for the miracle of a new possible endovascular treatment of MS ("liberation procedure"). We critically summarize the available evidence on CCSVI discussing inconsistent and incomplete replication of the original results by different groups, methodological limitations and potential therapeutic implications. We conclude that the available data are insufficient to establish conclusively a clear relationship between MS and CCSVI and do not support the role of CCSVI as the primary cause of MS. Until credible scientific evidence replicates the original results, any proposed invasive treatments of CCSVI should be discouraged..[Chiara:2011]
- Chronic cerebrospinal venous insufficiency ( CCSVI) has been postulated as a cause for multiple sclerosis (MS). Venous pressure assessments have not been made. Intracranial venous pressure was assessed using ophthalmodynamometry in 29 MS patients and compared with 28 healthy controls and 19 cases with elevated intracranial pressure (ICP). MS and control subjects had normal venous pressures (mean 15.5 resp. 15.1 cmHg). Only cases with intracranial pressure pathology had elevated venous pressures (mean 28.8 cmHg). There is no evidence of an increased intracranial venous pressure in MS patients..[Rolf:2011]
- Chronic cerebrospinal venous insufficiency ( CCSVI) has been postulated as a cause for multiple sclerosis (MS). Venous pressure assessments have not been made. Intracranial venous pressure was assessed using ophthalmodynamometry in 29 MS patients and compared with 28 healthy controls and 19 cases with elevated intracranial pressure (ICP). MS and control subjects had normal venous pressures (mean 15.5 resp. 15.1 cmHg). Only cases with intracranial pressure pathology had elevated venous pressures (mean 28.8 cmHg). There is no evidence of an increased intracranial venous pressure in MS patients..[Rolf:2011]{Human}
- The Canadian Institutes of Health Research and the Multiple Sclerosis (MS) Society of Canada recently convened an Invitational Panel to consider the scientific evidence linking chronic cerebrospinal venous insufficiency ( CCSVI) and MS. The panel supported studies to determine whether CCSVI causes MS, but felt that there is currently so much uncertainty about the relationship between CCSVI and MS that a clinical trial is not indicated at this time..[Andreas:2011]
- Cerebrospinal fluid (CSF) flow dynamics, which supposedly have a strong relationship with chronic cerebrospinal venous insufficiency ( CCSVI), might be expected to be affected in multiple sclerosis (MS) patients..[Gorucu:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the " venous hemodynamic insufficiency severity score" (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits [2]. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints..[Reekers:2011]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the " venous hemodynamic insufficiency severity score" (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits [2]. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints..[Reekers:2011]{Human}
- A critical analysis of the scientific methods used in the original studies of chronic cerebrospinal venous insufficiency in multiple sclerosis reveals several methodological problems with regard to potential bias and confounding. The current evidence calls into question whether chronic cerebrospinal venous insufficiency in multiple sclerosis exists at all..[Bridget:2011]{Human}
- A new nosologic vascular pattern that is defined by chronic cerebrospinal venous insufficiency ( CCSVI) has been strongly associated with multiple sclerosis..[Paolo:2009]{Human}
- The hypothesis proposes mechanisms by which an infective venous vasculitis could result in the specific neural damage, metabolic, immunological and vascular effects observed in MS. The hypothesis described is consistent with many of the known facts of MS pathogenesis and therefore provides a framework for further research into a venous aetiology for the disease.If MS does result from a chronic infective venulitis rather than a syndrome involving congenital truncular venous malformations, then additional therapies to the currently used angioplasties will be required to optimize results..[Thibault:2012]
- The condition was named chronic cerebrospinal venous insufficiency ( CCSVI)..[Yára:2011]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Studies using ultrasound in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 70%; range 0-100%; N.=1496), whereas, in normal controls and patients without MS the prevalence was much lower (mean 10%; range 0-36%; N.=635). Ultrasound uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results..[Zamboni:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) represents a recently described condition that may potentially contribute to the symptoms experienced by patients with multiple sclerosis. The evaluation of a prospective patient for CCSVI often involves an invasive evaluation with venography of the internal jugular and azygos veins. The purpose of this article is to review the normal anatomy of the internal jugular, vertebral, and azygos veins, as an understanding of these veins is necessary for appropriate interpretation of the venograms obtained to evaluate patients for CCSVI..[John:2011]
- Zamboni et al proposed a new hypothesis for the pathomechanisms of multiple sclerosis (MS): chronic cerebrospinal venous insufficiency ( CCSVI). Using Doppler ultrasound and venograms, they found severe extracranial venous stenosis in MS patients. They suggested that a venous obstruction in the neck caused a reflux back into the brain, which led to edema and demyelination..[Masami:2011]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a term used to describe impaired venous drainage from the central nervous system (CNS) caused by abnormalities in anatomy and flow affecting the extracranial veins. Recently, it has been proposed that CCSVI may contribute to the pathogenesis of multiple sclerosis (MS). It is hypothesized that venous obstruction results in abnormal flow that promotes inflammation at the blood-brain barrier and that this triggers a process marked by a disturbance of homeostasis within the CNS that leads to demyelination and neurodegeneration. The venous abnormalities of CCSVI are often diagnosed by ultrasound or magnetic resonance venography, however the prevalence of CCSVI detailed in groups of MS patients and patients without MS varies widely in published reports. Increased standardization of diagnostic studies to evaluate both anatomical and physiological findings associated with CCSVI is needed. The purpose of this article is to provide a background to understand the development of the theory of CCSVI and to frame the relevant issues regarding its diagnosis and relationship to the pathogenesis of MS..[Dake:2012]
- Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) by an unknown pathogenesis. MR venography and postmortem studies have demonstrated a topographic correspondence between multiple sclerosis (MS) plaques and the cerebral venous system pathology. In recent observational studies performed on patients from distinctive gene pools, the prevalence of chronic cerebrospinal venous insufficiency ( CCSVI) in MS ranged from 56% to 100%. Endovascular treatment (percutaneous transluminal angioplasty (PTA) with or without stenting) of CCSVI was reported to be feasible with a minor complication rate. In 4 patients with different forms of multiple sclerosis venography was performed that revealed stenosis of the proximal region of the jugular vein (right or left)..[Kipshidze:2011]
- The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed..[Jacek:2011]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure..[Zamboni:2010]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure..[Zamboni:2010]{Human}
- Recent clinical studies have suggested a relationship between multiple sclerosis (MS) and the occurrence of pathological changes in the jugular, vertebral and azygous veins that result in abnormal blood outflow from the brain and the spinal cord. Together, these pathological changes have been designated chronic cerebrospinal venous insufficiency ( CCSVI). The aim of the present study was to evaluate the usefulness of duplex Doppler ultrasound in the evaluation of central nervous system venous outflow disturbances in patients suffering from MS..[Zaniewski:2012]
- The pyramidal pathway is frequently affected early on in multiple sclerosis (MS) and impaired motor performance is a major cause of disability..[Plasmati:2010]{Human}
- The aetiology of multiple sclerosis remains unknown at the present time, although the most likely explanation is that it has an autoimmune inflammatory origin. During the history of this disease a vascular pathophysiology was once proposed, and it has recently re-emerged as a result of the work by Paolo Zamboni with the name of ' chronic cerebrospinal venous insufficiency'. Following this hypothesis, Zamboni puts forward a curative treatment for multiple sclerosis by means of endovascular treatment of the internal jugular vein and the azygos vein..[Carmen:2011]
- However, over the same nineteen-month period, the internet discussion on the subject of CCSVI and MS has led to countless websites advertising treatment using vascular surgery for patients with MS all over the world. The treatment based on the CCSVI theory has appealingly been called "liberation treatment", thus making it difficult to explain to patients why a treatment that has been highly praised (on the internet) cannot be recommended based on partial medical results that await confirmation..[Yára:2011]{Human}
- The presence of chronic cerebrospinal venous insufficiency ( CCSVI) was defined according to previously reported criteria for the extracranial and transcranial US techniques..[Marcello:2012]
- The discovery of stenoses in the azygous and internal jugular veins, the so-called chronic cerebrospinal venous insufficiency that accompanies multiple sclerosis, has enabled the reinterpretation of knowledge about this neurologic disease. Pathologic venous outflow from the central nervous system appears to lead to two main problems..[Marian:2012]
- Key Points • Chronic cerebrospinal venous insufficiency is a controversial topic in multiple sclerosis. • Ultrasound assessment of extracranial veins has yielded different results in the literature. • These differences may be due to dependence on Doppler and selection bias. • We found variations in vertebral vein flow in patients with multiple sclerosis..[Fatih:2011]
- We aim to present a very rare case of chronic cerebrospinal venous insufficiency due to both brachiocephalic vein obstruction by aberrant right subclavian artery and internal jugular vein distal compression by first cervical vertebra transverse process, demonstrated by multislice computerized tomography in a patient with multiple sclerosis..[Djordje:2012]
- Chronic cerebrospinal venous insufficiency has recently been proposed to be etiologic to multiple sclerosis..[Bridget:2011]{Human}
- Multiple sclerosis is highly correlated with chronic cerebrospinal venous insufficiency..[Simka:2010]{Human}
- Background Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system, believed to be triggered by an autoimmune reaction to myelin. Recently, a fundamentally different pathomechanism termed ' chronic cerebrospinal venous insufficiency' ( CCSVI) was proposed, provoking significant attention in the media and scientific community..[Christoph:2011]
- Azathioprine is an immunosuppressive drug widely used in the treatment of chronic inflammatory diseases, including Multiple Sclerosis (MS). We report two patients who developed the first manifestations of clinically definite multiple sclerosis while on long term (3.5 and 10 years, respectively) treatment with azathioprine for Crohn's disease..[Constantinescu:2000]{Human}
- Our findings showed a positive association between chronic cerebrospinal venous insufficiency and multiple sclerosis..[Andreas:2011]{Human}
- PTA seems to be an effective treatment for patients with CCVI and multiple sclerosis, However, randomized studies are warranted to establish the efficacy of this new treatment for MS..[Kipshidze:2011]
- Clinicians should be aware that endovenous treatment of CCSVI could cause paradoxical deterioration of cerebral venous drainage..[null:2011]{Human}
- The name multiple sclerosis (MS) refers to 2 features of the disease: multiple describes the number of central nervous system lesions and sclerosis refers to the demyelinated nature of the lesions..[Melody:2009]{Human}
- Currently, there is inconclusive evidence to support CCSVI as an etiological factor in patients with multiple sclerosis..[Amer:2011]
- Although cyclophosphamide pulse therapy has been reported to be beneficial for patients with chronic progressive multiple sclerosis for whom other treatment modalities are not expected to improve outcome, the experience with Japanese patients has not been shown in the literature..[Watanabe:1993]{Human}
- To the contrary, substitute circles are alternative pathways or vicarious venous shunts, which permit the drainage and prevent intracranial hypertension. In accordance with the pattern of obstruction, even the intracranial and the intrarachidian veins can also become substitute circles; they permit redirection of the deviated flow, piping the blood toward available venous segments outside the central nervous system. We review the complex gross and radiological anatomy of collateral circulation found activated by the means of EchoColor-Doppler and selective venography in the event of CCSVI, focusing particularly on the suboccipital cavernous sinus (SCS), the condylar venous system, the pterygoid plexus, the thyroid veins, and the emiazygous-lumbar venous anastomosis with the left renal vein..[Paolo:2009]{Human}
- In one case plaques of multiple sclerosis were found in the spinal cord. Those two cases are unusual forms of a diffuse disseminated sclerosis: multiple sclerosis and Schilder's disease are considered as two anatomo-clinical variants of the same pathological process. The observed necrotic lesions are different from the acute necrotic forms of multiple sclerosis as the latter have rapidly developed..[Lhermitte:1982]{Human}
- Minocycline, a commonly prescribed tetracycline antibiotic, has shown promise as a potential therapeutic agent in animal models of numerous neurologic disorders such as amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, Huntington's disease, stroke, and spinal cord injury (SCI)..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- Further interest has been generated by the idea of chronic cerebrospinal venous insufficiency that might be associated with brain iron accumulation due to a reduction in venous outflow, but its existence and etiologic role in MS are currently controversially debated..[Michael:2011]
- The autopsy showed characteristic "old" plaques of multiple sclerosis in the cerebrum with anterior horn cell and pyramidal tracts degeneration, typical of amyotrophic lateral sclerosis, in the spinal cord. Although exceptional, this association of amyotrophic lateral sclerosis and multiple sclerosis leads to the discussion of an etiological immunological dysregulation common to these two diseases..[Confavreux:1994]{Human}
- A potential shift in the treatment paradigm of MS involving endovascular balloon angioplasty or venous stent placement has been proposed as well as conducted in small patient series..[Omar:2010]{Human}
- Cerebrospinal fluid analysis was consistent with multiple sclerosis. The patient died of respiratory failure two years after presentation, and autopsy revealed multifocal demyelination involving the corpus callosum, cerebellum and spinal cord as well as pathologic findings typical of amyotrophic lateral sclerosis. A review of the literature confirms the exceedingly unusual combination of amyotrophic lateral sclerosis with multiple sclerosis..[Dynes:2001]{Human}
- A patient with ankylosing spondylitis developed a neurological disorder suggesting multiple sclerosis. An increased level of gammaglobulin was detected in the analysis of the cerebro spinal fluid. The response to steroid therapy, however, was unusual to that of multiple sclerosis since clinical manifestations disappeared shortly after, recurred some months later after discontinuance of the treatment, and subside again when the administration of corticosteroids was repeated..[Garc?a:1980]{Human}
- Although frequently suggested in the lay press, there is no proven effect in other indications, such as amyotrophic lateral sclerosis, multiple sclerosis and myocardial infarction..[Braat:2006]{Human}
- The prevailing view on multiple sclerosis etiopathogenesis has been challenged by the suggested new entity chronic cerebrospinal venous insufficiency. To test this hypothesis, we studied 21 relapsing-remitting multiple sclerosis cases and 20 healthy controls with phase-contrast magnetic resonance imaging. In addition, in multiple sclerosis cases we performed contrast-enhanced magnetic resonance angiography. We found no differences regarding internal jugular venous outflow, aqueductal cerebrospinal fluid flow, or the presence of internal jugular blood reflux..[Peter:2010]{Human}
- Multiple sclerosis is a chronic autoimmune disease affecting the central nervous system, more specifically, the myelin sheath covering of nerve fibers in the brain and spinal cord. This disease requires lifelong disease-modifying therapy, and all of the currently available first-line disease-modifying agents are parenteral formulations only..[Kristen:2010]{Human}
- Although comparing these new drugs with available therapies is difficult, they do show promise as potential first-line agents for the treatment of multiple sclerosis. This marks a new frontier in the treatment of this disease, as the advent of new oral drugs will lead to increased patient compliance and contribute to longer sustained symptom-free periods and less marked disability..[Kristen:2010]{Human}
- In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence..[Reekers:2011]
- In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence..[Reekers:2011]{Human}
- The treatment is called "liberation treatment," and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment..[Reekers:2011]
- The treatment is called "liberation treatment," and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment..[Reekers:2011]{Human}
- This study demonstrates that venous outflow disturbances in the form of CCSVI significantly impact on CSF pathophysiology in patients with MS..[Zamboni:2009]{Human}
- This study is in agreement with the other series reported from Asia regarding the special clinical features of multiple sclerosis described from this part of the world. There is more common occurrence of visual impairment at onset, predominant involvement of optic nerves and spinal cord and higher incidence of classical neuromyelitis optica. There is no relationship of any or all cerebro spinal fluid abnormalities with the type of multiple sclerosis, duration of an attack and disability, except for the possible relation between the type of colloidal gold reaction pattern and the type of multiple sclerosis..[Chopra:1981]{Human}
- Extra- and intracranial venous flow direction was assessed by colour-coded duplex sonography, and extracranial venous cross-sectional area (VCSA) of the internal jugular and vertebral veins (IJV/VV) was measured in B-mode to assess the five previously proposed CCSVI criteria..[Christoph:2011]
- CDMS is strongly associated with CCSVI, a scenario that has not previously been described, characterised by abnormal venous haemodynamics determined by extracranial multiple venous strictures of unknown origin. The location of venous obstructions plays a key role in determining the clinical course of the disease..[Zamboni:2009]{Human}
- Current medication used in MS treatment as well as medications about to be approved are primarily anti-inflammatory therapies. By modulating the immune system and thereby blocking key steps of the pathology, the immunomodulation therapies in MS have a slight impact on disability progression. There is, however, clinical and experimental data concerning the potential neuroprotective properties of novel therapies. Combining anti-inflammatory and direct neuroprotective or even neuroregenerative therapy strategies would be a step forward in the treatment of multiple sclerosis..[Zipp:2011]{Human}
- In the material of patients with trigeminal neuralgia treated by retrogasserian glycerol injection at the Karolinska Hospital, 23 cases (8%) were also diagnosed as suffering from disseminated sclerosis. These patients were often on carbamazepine treatment before the procedure, a regimen known to cause severe side effects and increase pre-existing symptoms in patients with multiple sclerosis. Following glycerol injection, more than 90% became pain-free within the first 2 months and 82% could discontinue drug therapy. This initial outcome corresponds well to the results in our larger series, but the long-term results in the group with multiple sclerosis is less satisfactory, with 61% recurrence at follow-up 8-79 months following treatment..[Linderoth:1989]{Human}
- This is an attempt to review the status of current therapy and future prospects in the treatment of MS..[Khan:1996]{Human}
- This review discusses the status of current and future therapy in the treatment of MS. Multiple sclerosis (MS) is the most common demyelinating disease of the human central nervous system (CNS)..[Khan:1996]{Human}
- The medical situations associated with an increased risk of thrombosis which are well documented are cancer, myocardial infarction, cardiac insufficiency, ischemic cerebro-vascular accidents with paralysis of lower limb(s), acute respiratory insufficiency in patients admitted to intensive care unit, prolonged immobilisation in elderly invalid patients and paralysis of the limbs due to spinal trauma. Prophylactic treatment in medical patients is still empirical..[Samama:1996]{Human}
- Multiple sclerosis (MS) is a chronic neurological disease that typically affects young adults..[Yára:2011]{Human}
- Only one healthy control and no MS patients fulfilled at least two criteria for CCSVI. Conclusions This triple-blinded extra- and transcranial duplex sonographic assessment of cervical and cerebral veins does not provide supportive evidence for the presence of CCSVI in MS patients. The findings cast serious doubt on the concept of CCSVI in MS..[Christoph:2011]
- Concepts of multiple sclerosis (MS) have shifted from the traditional view of a T cell-mediated, demyelinating disease of the white matter to include a broad range of immunopathogenic mechanisms, axonal damage, and widespread gray matter pathology. The cause of MS remains unknown, but recent epidemiological work has focused on genetic factors; environmental factors such as vitamin D, sunlight, and Epstein-Barr virus; and the controversial theory of chronic cerebrospinal venous insufficiency..[Daniel:2012]
- Here, we report on 3 cases with chronic progressive multiple sclerosis who have undergone the pulse-dose cyclophosphamide treatment. The cases included 3 women, two with primary progressive multiple sclerosis (one, the classical form and the other, the spinal cord from). The 3rd case was that of myelitis-optic neuritic form and the total blindness of right eye (left side had been totally blind) was impending despite repeated corticosteroid therapies..[Watanabe:1993]{Human}
- Newman, a young physician returning from Aberdeen University, made first mention of MS in the Australian literature when he gave a dissertation entitled 'On insular sclerosis of the brain and spinal cord' which was based on Charcot's teachings..[Frith:1989]{Human}
- A new sign of multiple sclerosis, the contracting cord sign, is described. The myelographic demonstration of a large cord that subsequently decreases in size may suggest multiple sclerosis. Multiple sclerosis must be considered in the differential diagnosis of an enlarged spinal cord..[Haughton:1979]{Human}
- Conclusions: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis..[Renzo:2011]
- Moreover, brain hypoperfusion may lead to chronic fatigue and other global neurologic symptoms. It is hoped that this review will help to elucidate new strategies and treatments for multiple sclerosis and will show new avenues for the research on this debilitating disease..[Marian:2012]
- We conducted a qualitative inquiry in order to describe the meaning of women's experiences of living with multiple sclerosis (MS). Multiple sclerosis is a chronic autoimmune disease of the central nervous system..[Malin:2008]{Human}
- The myelinotoxicity of sera from multiple sclerosis (MS) patients was determined by the assessment of visible myelin damage in guinea-pig spinal cord-spinal ganglia and in rat cerebella cultivated on collagen-coated coverslips in Leighton tubes..[Hauw:1987]{Human}
- These findings may support the venous occlusion theory, but may also be explained by atrophy-dependent ventricular dilatation independent of the venous theory in MS patients..[Gorucu:2012]
- Neutral protease activity was significantly elevated in the cerebro-spinal fluid of patients with multiple sclerosis (MS) in exacerbation and in the acute phase of acute viral meningoencephalitis (AME) compared with that of MS in remission, amyotrophic lateral sclerosis or psychosomatic disease..[Inuzuka:1987]{Human}
- A disability-scoring and an EEG-spectral analysis was performed in patients suffering from clinically and biochemically (oligoclonal aspect in cerebro-spinal fluid) proven multiple sclerosis at two stages of their illness, that are before and after a short intensive immuno suppressive therapy..[Colon:1982]{Human}
- Conversely, in chronic inflammation of the central nervous system (CNS), atrophy has previously also been described and neurodegeneration is discussed as a pathologic feature. The most frequent chronic inflammatory disease of the CNS is multiple sclerosis (MS), which leads to devastating relapsing-remitting symptoms and disability during the relapses, increasingly during the course of disease in patients. Meanwhile it became clear that axons already reveal pathology early in the disease and neurons are affected in the cortex and the spinal cord, albeit to a different extent..[Zipp:2011]{Human}
- Interferon beta-1b (Betaseron), a drug that affects the natural course of the disease, was developed for the treatment of relapsing-remitting MS. Multiple Sclerosis Pathways (MSP), a disease management program, was developed to provide comprehensive and personal support to MS patients taking interferon beta-1b and to serve as an information resource for all people with MS, their families, and healthcare professionals..[Madonna:2000]{Human}
- The ionophoretic stimulation of granulocytes incubated with thrombocytes caused marked inhibition of leucocyte adherence in healthy controls and to a significantly smaller extent in patients with multiple sclerosis without corticosteroid treatment..[Mayer:1990]{Human}
- In conclusion the B cell tolerizing effect of spMBP82-98 segregated into four kinetic profiles; this molecular variability should be considered in attempts to develop specific 'peptide therapies' for the broad range of clinical profiles currently diagnosed as ' multiple sclerosis'. Multiple Sclerosis (2000) 6 300 - 311.[Warren:2000]{Human}
- An analysis was performed of features of incipient manifestations of multiple sclerosis in 648 patients with a primary diagnosis having been made at the Ukrainian Centre for Study of Demyelinating Diseases over 1992-1996. Incipient manifestations of disseminated sclerosis revealed themselves predominantly as sensory, motor, visual, and coordination impairment against the background of pain sensations, paresthesias and pronounced asthenia of the nervous system. Knowledge of disseminated sclerosis debut is important for the diagnosis of the condition to be made and treatments to be administered in a timely fashion..[Vinychuk:1998]{Human}
- The analysis of clinical neurological symptoms on the basis of available letters and other documents confirms beyond a doubt the long standing diagnosis of neurosyphilis in the form of chronic meningitis with cranial polyneuritis and wide spread polyradiculitis, formerly called Lues cerebro-spinalis. The symptoms which recurred over 25 years include multiple severe paralysis of cranial nerves, dramatic radicular neuralgias and radicular paralysis in addition to a partial transverse lesion of the spinal cord and terminal coughing and regurgation fits in the absence of symptoms in the cerebrum and brain stem, these symptoms hardly permit different diagnosis. Tuberculosis, lead poisoning, multiple sclerosis or even a myatrophic lateral sclerosis do not explain his neurological symptoms or the cause of his death..[Schiffter:2005]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- The pathophysiology of CCSVI is yet to be defined. The superior cava venous system is highly complex in terms of anatomy and possible anomalies, as well as its haemodynamic mechanisms. Further studies are required to define the parameters of diagnosis and treatment of CCSVI..[Lugli:2012]
- Tumor necrosis factor (TNF) alpha, interleukins (IL) 2, 4, 6, and 10, and IgG oligoclonal bands (IgG OB) in vitro production was assessed, after whole-blood stimulation with lipopolysaccharide or concanavalin A, in 61 patients presenting with relapsing-remitting, relapsing-progressive, or chronic progressive multiple sclerosis. Multiple sclerosis patients were receiving no treatment or azathioprine (AZA), cyclosporin, cyclophosphamide, subcutaneous interferon (IFN) beta 1 a, or corticosteroids (CST)..[Schluep:2000]{Human}
- This study also revealed a correlation between the occurrence of inverted flow in patients in a sitting position and chronic progressive MS (P = 0.0033). The examinations undertaken indicate a possible connection between MS and CCSVI. The widely accessible and highly sensitive and specific Doppler ultrasound test may be useful for revealing, and preliminary analysis of, CCSVI pathologies..[Zaniewski:2012]
- In conclusion, we can state that the result of endovascular treatment seems to decay although the baseline is still higher than preoperative..[Beelen:2012]
- Several scientific endeavors examining the presence of CCSVI in MS are being undertaken. At present, invasive and potentially dangerous endovascular procedures as therapy for patients with MS should be discouraged until such studies have been completed, analyzed, and debated in the scientific arena..[Omar:2010]{Human}
- Two of them presented with concomitant, relatively rare disabling neurological diseases, namely amyotrophic lateral sclerosis and multiple sclerosis..[Renzo:2011]
- Spasticity occurs in children and adults due to a wide range of conditions, including cerebral palsy, head and spinal cord trauma, cerebrovascular accidents and multiple sclerosis. Multiple treatment options have been described, including medical and surgical treatments..[von:2001]{Human}
- Multiple sclerosis (MS) is an incurable neurological illness that frequently causes chronic disability..[Khan:1996]{Human}
- All participants underwent ultrasonography (US) to detect signs of CCSVI. CCSVI was detected in 55% of patients in the MS group and 35% in the control group; the difference was not statistically significant (p=0.089). In our experience, a slight difference exists in the prevalence of CCSVI between MS and healthy controls, but it is not as yet clear which parameters may be most significant. This preliminary study failed to show a statistically significant difference in the prevalence of CCSVI among patients affected by MS..[Floris:2012]
- Multiple sclerosis (MS) is a chronic progressive disease which is the leading cause, after road traffic accidents, of handicap in young subjects..[Donz?:2007]{Human}
- The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment..[Reekers:2011]
- The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment..[Reekers:2011]{Human}
- Other disorders such as bilateral internal and external jugular venous ligation or radical neck dissection, which result in venous stasis, are not known causes of demyelination in the central nervous system. Our data also does not support the hypothesis of CCSVI theory, despite the fact that our study was limited to a small group of patients and the examination was performed only using Doppler ultrasound..[Masami:2011]{Human}
- To investigate the differences between multiple sclerosis (MS) and control subjects by using extracranial venous grey-scale, colour and spectral Doppler ultrasound..[Fatih:2011]
- MS ( multiple sclerosis) is a chronic autoimmune and neurodegenerative pathology of the CNS (central nervous system) affecting approx. 2.5 million people worldwide..[Yossan-Var:2011]
- Currently available disease-modifying therapies (DMTs) are known to be only partially effective in adults with multiple sclerosis (MS)..[Ann:2010]
- Overall, 144 children (55.8%) continued receiving 1 therapy, while 65 (25.2%), 29 (11.2%), and 20 (7.8%) received 2, 3, or 4 or more sequential therapies, respectively, during a mean (SD) observation period of 3.9 (2.8) years. Second-line DMT use was restricted to interferon beta and glatiramer acetate in 203 children (78.7%), whereas other treatments such as broad-spectrum chemotherapies (cyclophosphamide, mitoxantrone hydrochloride), natalizumab, corticosteroids (monthly), and daclizumab were used at some point during the observation period for disease management in 55 children (21.3%)..[Ann:2010]
- Three types of vascular dysfunction have been described in multiple sclerosis (MS)..[Miguel:2011]{Human}
- Multiple sclerosis (MS), a chronic disease of the central nervous system, is characterized by a variable and unpredictable course..[Madonna:2000]{Human}
- Pathologically, MS is associated with focal areas of myelin destruction, inflammation, and axonal transection ("demyelinating plaques") in the brain and spinal cord..[Claudiu:2012]
- Multiple sclerosis (MS) is a disease of the white matter. Magnetic resonance imaging (MRI) is proven to be a sensitive method of monitoring the progression of this disease and of its changes due to treatment protocols. Quantification of the severity of the disease through estimation of MS lesion volume via MR imaging is vital for understanding and monitoring the disease and its treatment..[Udupa:1997]{Human}
- OPINION Multiple sclerosis (MS) is a relapsing and progressive disorder of the central nervous system..[Claudiu:2012]
- Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy..[Renzo:2011]
- Spinal cord MRI may provide information about disease progression that is not readily available from brain MRI scans and could be useful in diagnosing MS in some cases, as well as for monitoring the effects of treatments..[Christopher:2005]{Human}
- A twenty-five year old woman developed a progressive right hemiparesis which remitted within three months, without treatment. The diagnosis was a first relapse of multiple sclerosis..[Confavreux:1994]{Human}
- Ultrasound in the form of duplex scanning uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results..[Nicolaides:2012]
- In 1993, Food and Drug Administration (FDA) approved Betaseron for the treatment of MS. Todate, this is the only drug approved by the FDA, specifically for the treatment of MS..[Khan:1996]{Human}
- This study suggests that a multimodal non-invasive approach (DS and MRV) increases the specificity for a diagnosis of CCSVI in patients with MS..[Dolic:2012]
- Fifty-four patients, with multiple sclerosis from North-West India are described. This included two pathologically proven cases of multiple sclerosis..[Chopra:1981]{Human}
- Multiple sclerosis is a complex inflammatory disease of the central nervous system that is variable in terms of symptoms and presentation. The objectives of this article are to review briefly the epidemiology and pathophysiology of MS and to focus on the major categories of therapies currently in use to treat MS..[Melody:2009]{Human}
- In this Point of View, we discuss the recent investigations that led to the description of CCSVI as well as the conceptual and technical shortcomings that challenge the potential relationship of this phenomenon to MS..[Omar:2010]{Human}
- Our main conclusion is that, given the results we currently have available, we should be cautious and, for the time being, it would be advisable not to recommend the systematic use of this treatment for our patients..[Carmen:2011]
- Although switching between first-line DMTs may be effective in pediatric patients with disease that is refractory to initial treatment, a subset of patients may require second-line therapeutic interventions..[Ann:2010]
- A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined..[Barlow:2010]{Human}
- A growing body of evidence indicates that irreversible tissue destruction including axonal and neuronal degeneration is a key component of the multiple sclerosis (MS) disease process. Magnetic resonance imaging (MRI) is a powerful technique that can be combined with semiautomated or automated computer assisted analysis approaches to detect progressive atrophy of the brain and spinal cord with high sensitivity and reproducibility. The pathophysiology of central nervous system (CNS) atrophy in MS is unknown but likely represents an epiphenomenon related to the effects of inflammation including chronic demyelination, axonal injury, neuronal loss and Wallerian degeneration..[Robert:2004]{Human}
- The prevalence of CCSVI was higher in patients with MS than in control subjects (77% vs 28%, P < .0001). CCT was not significantly different between patients with MS who had CCSVI and patients with MS who did not (P = .182)..[Marcello:2012]
- The diagnostic value of CSF oligoclonal IgG bands, intrathecal IgG synthesis, cytology and markers of myelin breakdown in the cerebro-spinal fluid were evaluated in multiple sclerosis..[Schmidt:1987]{Human}
- Multiple Sclerosis (2000) 6 362 - 363.[Constantinescu:2000]{Human}
- Endovascular treatment of CCSVI is a safe procedure; there is a 1.6% risk of major complications..[Kenneth:2012]
- Multiple sclerosis (MS) is a chronic neurological condition characterized pathologically by axonal loss, demyelination, inflammation, and gliosis. Magnetic resonance imaging (MRI) has had a major impact on diagnosing MS, understanding the condition, and monitoring the effects of treatments. Recently, spinal cord MRI has received increased attention. Advanced techniques have been used to image the spinal cord, particularly the cervical cord, and measure quantitative parameters such as T1 relaxation time, magnetization transfer ratio, and diffusivity..[Christopher:2005]{Human}
- The corticospinal and rubrospinal tracts were traced and the spinal cords were harvested 7 weeks after injury. The extent of gray matter and white matter sparing and corticospinal and rubrospinal tract sprouting were evaluated in cross sections of the spinal cord. In the end, neither minocycline nor simvastatin treatment was associated with improved performance on the behavioral tests, as compared to saline controls..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- In the future, rehabilitation professionals will have to learn how to anticipate patient needs and lay the groundwork for services and equipment in advance. Rehabilitation is one of the treatments of MS patients and should be viewed as an ongoing process to maintain and restore maximum function and quality of life..[Donz?:2007]{Human}
- Multiple sclerosis (MS) is primarily an autoimmune disorder of unknown origin. This review focuses iron overload and oxidative stress as surrounding cause that leads to immunomodulation in chronic MS..[Ajay:2009]{Human}
- The presence of IL-2 receptor and HLA class II antigens as detected by monoclonal antibodies on mononuclear cells from both cerebro-spinal fluid (CSF) and peripheral blood was examined by cytofluorographic analysis in patients with multiple sclerosis (MS) and other neurological diseases..[Tournier-Lasserve:1987]{Human}
- The aim of this study was to simultaneously measure in vivo volumes of gray matter (GM), normal white matter (WM), abnormal white matter (aWM), and cerebro-spinal fluid (CSF), and to assess their relationship in 50 patients with relapsing-remitting multiple sclerosis (RR-MS) (age range, 21-59; mean EDSS, 2.5; mean disease duration, 9.9 years), using an unsupervised multiparametric segmentation procedure applied to brain MR studies..[Mario:2003]{Human}
- This focus group, qualitative study (N = 18) reports the psychosocial impact, specifically, of spasticity symptoms on a sample of people with MS ( multiple sclerosis). MS, a chronic disabling disease which attacks the central nervous system, currently affects about 100,000 people in the UK and estimates indicate that worldwide prevalence varies from around 10 to 250 per 100,000..[Nicolson:2011]
- T-cell clones derived from the CSF (cerebrospinal fluid) of MS ( multiple sclerosis) patients have been analysed for the production of interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-4 (IL-4). Each CSF-T clone (both CD4+ and CD8+) produced substantial amounts of IFN-gamma and especially TNF-alpha compared with autologous peripheral T clones and liver-infiltrating T clones from patients with chronic active hepatitis..[Buttinelli:1994]{Human}
- Purpose: To assess cerebral circulation times (CCTs) in patients with multiple sclerosis (MS) and control subjects by using contrast material-enhanced ultrasonography (US) to determine whether vascular abnormalities can be detected in this disease..[Marcello:2012]
- The present paper is based on an exact analysis of the neurootological findings in 30 cases of multiple sclerosis (MS)..[Meran:1977]{Human}
- In 1868 Jean-Martin Charcot's clinicopathological correlation of multiple sclerosis (MS) was published..[Frith:1989]{Human}
- HTLV-1 in endemic in populations which are recognized as having low risk of multiple sclerosis . Multiple sclerosis generally evolves as a relapsing-remitting disease and affects predominantly Caucasians..[Jo?l:2007]{Human}
- The results suggest a change of membrane properties, dependent on thrombocytes, in the early stage of non-specific granulocyte activation in patients with multiple sclerosis..[Mayer:1990]{Human}
- Atrophy should now be included as a secondary endpoint in trials of therapies aimed at limiting disease progression. Currently available anti-inflammatory immunomodulatory agents and immunosuppressive treatments, while effective at preventing clinical deterioration, have shown at best partial effects in preventing CNS atrophy. Thus, there is a need to further validate atrophy as an outcome measure and ultimately develop treatment strategies that will protect against the destructive aspects of the disease process..[Robert:2004]{Human}
- Multiple Sclerosis (2000) 6, 66 - 68.[Hay:2000]{Human}
- Emerging therapies are rapidly expanding treatment options, including both parenterally administered and oral medications..[Daniel:2012]
- Secondly, it may result in significant hypoperfusion of the brain and spinal cord..[Marian:2012]
- The study aimed to evaluate neopterin levels in cerebro-spinal fluid (CSF) as a marker of disease activation and progression of multiple sclerosis (MS)..[Tsolaki:2003]
- CD154 (CD40-ligand, gp39), expressed on activated T cells, is crucial in T cell-dependent immune responses and may be involved in the pathogenesis of multiple sclerosis (MS)..[Jensen:2001]{Human}
- The authors present a new technique for the analysis of the cerebro spinal fluid (C.S.F.) proteins: silver stain after isoelectric focusing with possibility of immunofixation..[Confavreux:1982]{Human}
- Multiple sclerosis fatigue was unrelated to either depression or global impairment. Multiple sclerosis fatigue appears to be a distinct clinical entity, often disabling, that can be distinguished from normal fatigue, affective disturbance, and neurologic impairment..[Krupp:1988]{Human}
- Increased iron deposition might be implicated in multiple sclerosis (MS)..[Michael:2011]
- Although the association of a clinical picture resembling multiple sclerosis with ankylosing spondylitis has been reported, there are a few, and sometimes poorly documented, published cases..[Garc?a:1980]{Human}
- Significant improvement in the clinical state of the patient and a marked increase of the mean alpha frequency in the parietooccipital region could be demonstrated after short intensive immunosuppressive therapy..[Colon:1982]{Human}
- Nineteen months after the original publication on CCSVI and MS, another 22 papers have been published addressing the matter..[Yára:2011]{Human}
- All the patients tolerated the therapy well..[Watanabe:1993]{Human}
- Although our study of the dynamics of TNF-alpha, IL-2, IL-4, IL-6, and IL-10 in vitro production generally found no statistically significant correlations (partly explained by the limited number of values in the various groups), IL-6 was shown to drop during the periods surrounding relapse (P = 0.05) in the absence of treatment, while TNF-alpha (P = 0.04) and IL-6 (P < 0.05) dropped before exacerbation in the presence of AZA..[Schluep:2000]{Human}
- The prevention of post-operative venous thromboembolic accidents is well documented..[Samama:1996]{Human}
- The first autopsy of a case of multiple sclerosis from the District of Hokuriku was reported..[Isaki:1980]{Human}
- The most common application of cord blood is in the treatment of (malignant) blood disorders..[Braat:2006]{Human}
- Clinical status was analysed as regards the age at onset, the duration and course of the disease, the disability of the patients and the treatment they received..[Davous:1978]{Human}
- Further studies are required to verify these observations and to clarify if CCT and CCSVI have any physiologic and clinical relevance in MS. © RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11111239/-/DC1..[Marcello:2012]
- In Asians MS affects preferentially the spinal cord..[Jo?l:2007]{Human}
- Lymphocytes subpopulations in cerebro-spinal fluid (CSF) and peripheral blood (PB) from multiple sclerosis (MS) patients were studied..[Manconi:1981]{Human}
- Late onset multiple sclerosis (LOMS), defined as the first presentation of clinical symptoms in patients over 50, is not a rare phenomenon as previously thought, since the prevalence ranges between 4% and 9.6% in different studies..[Martinelli:2005]{Human}
- No distribution of these bands, particularly in the more cathodal zone, seems to be specific of any disease including multiple sclerosis (M.S.)..[Confavreux:1982]{Human}
- Fatigue is a frequent symptom in multiple sclerosis (MS) that can interfere with a patient's daily functioning..[Krupp:1988]{Human}
- In conclusion, we found no evidence confirming the suggested vascular multiple sclerosis hypothesis..[Peter:2010]{Human}
- Detection frequency of human herpesvirus 6 (HHV-6) and Epstein Barr virus (EBV) DNA in multiple sclerosis (MS) patients and controls was investigated..[Hay:2000]{Human}
- Ultrasonography after the procedure is recommended to confirm venous patency and to identify patients experiencing acute venous thrombosis..[Kenneth:2012]
- A case of transitional type of multiple sclerosis with large periventricular cuffs of demyelination is presented..[Pruchnik:1994]{Human}
- Circulating immune complexes were looked for on 38 clinically definite MS ( multiple sclerosis) patients compared to 35 other neurological patients and 26 healthy subjects. 29% of the MS sera and 8.6% of the other neurological sera were positive, whereas none of the control sera were positive..[Davous:1978]{Human}
- The positive impact of education and support on adherence to therapy has been validated by training and nurse hotline data..[Madonna:2000]{Human}
- Histopathologically, there were many recent and old demyelinating lesions of varying sizes and shapes in all parts of the central nervous system, namely the cerebrum, brainstem, spinal cord and optic nerve..[Isaki:1980]{Human}
- LOMS is usually associated with a faster progression to disability compared to young adult multiple sclerosis (MS) patients..[Martinelli:2005]{Human}
- Since that time Australians have made an ever-increasing contribution to the world literature regarding MS pathogenesis, epidemiology and treatment..[Frith:1989]{Human}
- The purpose of this Phase I open label clinical study was to monitor CSF anti-MBP in patients with chronic progressive MS subsequent to IV administration of synthetic peptide (sp) MBP82-98 namely DEN(85)VVHFFKNIVTP(96)RT..[Warren:2000]{Human}
- Objective: Herein, we report 3 cases of SCH and suggest a possible association with trauma-related neurodegenerative or chronic inflammatory diseases..[Renzo:2011]
- Despite the technical difficulties of performing spinal cord MRI, imaging studies, particularly of the cervical cord, are becoming more common..[Christopher:2005]{Human}
- Electromyography demonstrated widespread active and chronic motor axon loss..[Dynes:2001]{Human}
- As both drugs have translational potential, we evaluated their neuroprotective properties here in a clinically relevant model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- In conclusion, both minocycline and simvastatin failed to improve functional and histological recovery in our model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- These 3 cases have shown neurological improvements or at least arrest of the progression following the therapy..[Watanabe:1993]{Human}
- Loss of neurons due to cell death and axonal degeneration characterize neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease or amyotrophic lateral sclerosis..[Zipp:2011]{Human}
- In patients with disseminated sclerosis and in a control group inhibition of granulocyte adherence was investigated after stimulation with the ionophore A23187 and the effect of autologous thrombocytes on this reactivity was investigated..[Mayer:1990]{Human}
- Multiple sclerosis [MS], a demyelinating disease of the central nervous system associated with inflammation and gliosis, may be an autoimmune disease with T lymphocytes and autoantibodies to myelin protein(s)..[Warren:2000]{Human}
- Many reports have been published on these different treatment options, but rarely has a comparison been made between them..[von:2001]{Human}
|
| [Central Nervous System]:1.0
- A chronic state of impaired venous drainage from the central nervous system, termed chronic cerebrospinal venous insufficiency ( CCSVI), is claimed to be a pathologic phenomenon exclusively seen in multiple sclerosis (MS)..[Omar:2010]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome recently described in multiple sclerosis patients. It is characterized by abnormal venous hemodynamics resulting from numerous obstacles in the main veins draining the central nervous system, usually: the internal jugular veins and the azygous vein..[Ma'moon:2012]
- Recent reports have emerged suggesting that multiple sclerosis (MS) may be due to abnormal venous outflow from the central nervous system, termed chronic cerebrospinal venous insufficiency ( CCSVI). These reports have generated strong interest and controversy over the prospect of a treatable cause of this chronic debilitating disease. This review aims to describe the proposed association between CCSVI and MS, summarize the current data, and discuss the role of endovascular therapy and the need for rigorous randomized clinical trials to evaluate this association and treatment..[Marc:2011]
- Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) by an unknown pathogenesis. MR venography and postmortem studies have demonstrated a topographic correspondence between multiple sclerosis (MS) plaques and the cerebral venous system pathology. In recent observational studies performed on patients from distinctive gene pools, the prevalence of chronic cerebrospinal venous insufficiency ( CCSVI) in MS ranged from 56% to 100%. Endovascular treatment (percutaneous transluminal angioplasty (PTA) with or without stenting) of CCSVI was reported to be feasible with a minor complication rate. In 4 patients with different forms of multiple sclerosis venography was performed that revealed stenosis of the proximal region of the jugular vein (right or left)..[Kipshidze:2011]
- The discovery of stenoses in the azygous and internal jugular veins, the so-called chronic cerebrospinal venous insufficiency that accompanies multiple sclerosis, has enabled the reinterpretation of knowledge about this neurologic disease. Pathologic venous outflow from the central nervous system appears to lead to two main problems..[Marian:2012]
- Background Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system, believed to be triggered by an autoimmune reaction to myelin. Recently, a fundamentally different pathomechanism termed ' chronic cerebrospinal venous insufficiency' ( CCSVI) was proposed, provoking significant attention in the media and scientific community..[Christoph:2011]
- The name multiple sclerosis (MS) refers to 2 features of the disease: multiple describes the number of central nervous system lesions and sclerosis refers to the demyelinated nature of the lesions..[Melody:2009]{Human}
- To the contrary, substitute circles are alternative pathways or vicarious venous shunts, which permit the drainage and prevent intracranial hypertension. In accordance with the pattern of obstruction, even the intracranial and the intrarachidian veins can also become substitute circles; they permit redirection of the deviated flow, piping the blood toward available venous segments outside the central nervous system. We review the complex gross and radiological anatomy of collateral circulation found activated by the means of EchoColor-Doppler and selective venography in the event of CCSVI, focusing particularly on the suboccipital cavernous sinus (SCS), the condylar venous system, the pterygoid plexus, the thyroid veins, and the emiazygous-lumbar venous anastomosis with the left renal vein..[Paolo:2009]{Human}
- Multiple sclerosis is a chronic autoimmune disease affecting the central nervous system, more specifically, the myelin sheath covering of nerve fibers in the brain and spinal cord. This disease requires lifelong disease-modifying therapy, and all of the currently available first-line disease-modifying agents are parenteral formulations only..[Kristen:2010]{Human}
- This review discusses the status of current and future therapy in the treatment of MS. Multiple sclerosis (MS) is the most common demyelinating disease of the human central nervous system (CNS)..[Khan:1996]{Human}
- Conclusions: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis..[Renzo:2011]
- We conducted a qualitative inquiry in order to describe the meaning of women's experiences of living with multiple sclerosis (MS). Multiple sclerosis is a chronic autoimmune disease of the central nervous system..[Malin:2008]{Human}
- Other disorders such as bilateral internal and external jugular venous ligation or radical neck dissection, which result in venous stasis, are not known causes of demyelination in the central nervous system. Our data also does not support the hypothesis of CCSVI theory, despite the fact that our study was limited to a small group of patients and the examination was performed only using Doppler ultrasound..[Masami:2011]{Human}
- MS ( multiple sclerosis) is a chronic autoimmune and neurodegenerative pathology of the CNS (central nervous system) affecting approx. 2.5 million people worldwide..[Yossan-Var:2011]
- Multiple sclerosis (MS), a chronic disease of the central nervous system, is characterized by a variable and unpredictable course..[Madonna:2000]{Human}
- OPINION Multiple sclerosis (MS) is a relapsing and progressive disorder of the central nervous system..[Claudiu:2012]
- Multiple sclerosis is a complex inflammatory disease of the central nervous system that is variable in terms of symptoms and presentation. The objectives of this article are to review briefly the epidemiology and pathophysiology of MS and to focus on the major categories of therapies currently in use to treat MS..[Melody:2009]{Human}
- This focus group, qualitative study (N = 18) reports the psychosocial impact, specifically, of spasticity symptoms on a sample of people with MS ( multiple sclerosis). MS, a chronic disabling disease which attacks the central nervous system, currently affects about 100,000 people in the UK and estimates indicate that worldwide prevalence varies from around 10 to 250 per 100,000..[Nicolson:2011]
- Histopathologically, there were many recent and old demyelinating lesions of varying sizes and shapes in all parts of the central nervous system, namely the cerebrum, brainstem, spinal cord and optic nerve..[Isaki:1980]{Human}
- Multiple sclerosis [MS], a demyelinating disease of the central nervous system associated with inflammation and gliosis, may be an autoimmune disease with T lymphocytes and autoantibodies to myelin protein(s)..[Warren:2000]{Human}
|
[Spinal Cord]:0.7212353
- Minocycline, a commonly prescribed tetracycline antibiotic, has shown promise as a potential therapeutic agent in animal models of numerous neurologic disorders such as amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, Huntington's disease, stroke, and spinal cord injury (SCI)..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- Newman, a young physician returning from Aberdeen University, made first mention of MS in the Australian literature when he gave a dissertation entitled 'On insular sclerosis of the brain and spinal cord' which was based on Charcot's teachings..[Frith:1989]{Human}
- A new sign of multiple sclerosis, the contracting cord sign, is described. The myelographic demonstration of a large cord that subsequently decreases in size may suggest multiple sclerosis. Multiple sclerosis must be considered in the differential diagnosis of an enlarged spinal cord..[Haughton:1979]{Human}
- Spasticity occurs in children and adults due to a wide range of conditions, including cerebral palsy, head and spinal cord trauma, cerebrovascular accidents and multiple sclerosis. Multiple treatment options have been described, including medical and surgical treatments..[von:2001]{Human}
- Pathologically, MS is associated with focal areas of myelin destruction, inflammation, and axonal transection ("demyelinating plaques") in the brain and spinal cord..[Claudiu:2012]
- Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy..[Renzo:2011]
- Multiple sclerosis (MS) is a chronic neurological condition characterized pathologically by axonal loss, demyelination, inflammation, and gliosis. Magnetic resonance imaging (MRI) has had a major impact on diagnosing MS, understanding the condition, and monitoring the effects of treatments. Recently, spinal cord MRI has received increased attention. Advanced techniques have been used to image the spinal cord, particularly the cervical cord, and measure quantitative parameters such as T1 relaxation time, magnetization transfer ratio, and diffusivity..[Christopher:2005]{Human}
- The corticospinal and rubrospinal tracts were traced and the spinal cords were harvested 7 weeks after injury. The extent of gray matter and white matter sparing and corticospinal and rubrospinal tract sprouting were evaluated in cross sections of the spinal cord. In the end, neither minocycline nor simvastatin treatment was associated with improved performance on the behavioral tests, as compared to saline controls..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- Secondly, it may result in significant hypoperfusion of the brain and spinal cord..[Marian:2012]
- The most common application of cord blood is in the treatment of (malignant) blood disorders..[Braat:2006]{Human}
- In Asians MS affects preferentially the spinal cord..[Jo?l:2007]{Human}
- Histopathologically, there were many recent and old demyelinating lesions of varying sizes and shapes in all parts of the central nervous system, namely the cerebrum, brainstem, spinal cord and optic nerve..[Isaki:1980]{Human}
- Despite the technical difficulties of performing spinal cord MRI, imaging studies, particularly of the cervical cord, are becoming more common..[Christopher:2005]{Human}
- In conclusion, both minocycline and simvastatin failed to improve functional and histological recovery in our model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- As both drugs have translational potential, we evaluated their neuroprotective properties here in a clinically relevant model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
|
[Cerebro-spinal Fluid CSF]:0.48729038
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a vascular picture that shows a strong association with multiple sclerosis (MS). The aim of this study was to investigate the relationship between a Doppler cerebral venous hemodynamic insufficiency severity score (VHISS) and cerebrospinal fluid (CSF) flow dynamics in 16 patients presenting with CCSVI and relapsing-remitting MS (CCSVI-MS) and in eight healthy controls (HCs)..[Zamboni:2009]{Human}
- Cerebrospinal fluid (CSF) flow dynamics, which supposedly have a strong relationship with chronic cerebrospinal venous insufficiency ( CCSVI), might be expected to be affected in multiple sclerosis (MS) patients..[Gorucu:2012]
- Neutral protease activity was significantly elevated in the cerebro-spinal fluid of patients with multiple sclerosis (MS) in exacerbation and in the acute phase of acute viral meningoencephalitis (AME) compared with that of MS in remission, amyotrophic lateral sclerosis or psychosomatic disease..[Inuzuka:1987]{Human}
- A disability-scoring and an EEG-spectral analysis was performed in patients suffering from clinically and biochemically (oligoclonal aspect in cerebro-spinal fluid) proven multiple sclerosis at two stages of their illness, that are before and after a short intensive immuno suppressive therapy..[Colon:1982]{Human}
- The diagnostic value of CSF oligoclonal IgG bands, intrathecal IgG synthesis, cytology and markers of myelin breakdown in the cerebro-spinal fluid were evaluated in multiple sclerosis..[Schmidt:1987]{Human}
- The presence of IL-2 receptor and HLA class II antigens as detected by monoclonal antibodies on mononuclear cells from both cerebro-spinal fluid (CSF) and peripheral blood was examined by cytofluorographic analysis in patients with multiple sclerosis (MS) and other neurological diseases..[Tournier-Lasserve:1987]{Human}
- The aim of this study was to simultaneously measure in vivo volumes of gray matter (GM), normal white matter (WM), abnormal white matter (aWM), and cerebro-spinal fluid (CSF), and to assess their relationship in 50 patients with relapsing-remitting multiple sclerosis (RR-MS) (age range, 21-59; mean EDSS, 2.5; mean disease duration, 9.9 years), using an unsupervised multiparametric segmentation procedure applied to brain MR studies..[Mario:2003]{Human}
- T-cell clones derived from the CSF (cerebrospinal fluid) of MS ( multiple sclerosis) patients have been analysed for the production of interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-4 (IL-4). Each CSF-T clone (both CD4+ and CD8+) produced substantial amounts of IFN-gamma and especially TNF-alpha compared with autologous peripheral T clones and liver-infiltrating T clones from patients with chronic active hepatitis..[Buttinelli:1994]{Human}
- The study aimed to evaluate neopterin levels in cerebro-spinal fluid (CSF) as a marker of disease activation and progression of multiple sclerosis (MS)..[Tsolaki:2003]
- Lymphocytes subpopulations in cerebro-spinal fluid (CSF) and peripheral blood (PB) from multiple sclerosis (MS) patients were studied..[Manconi:1981]{Human}
- The purpose of this Phase I open label clinical study was to monitor CSF anti-MBP in patients with chronic progressive MS subsequent to IV administration of synthetic peptide (sp) MBP82-98 namely DEN(85)VVHFFKNIVTP(96)RT..[Warren:2000]{Human}
|
[Cases of Multiple Sclerosis]:0.41110265
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a hypothesis through which cerebral venous drainage abnormalities contribute towards the pathogenesis of multiple sclerosis. CCSVI venoplasty is already practised worldwide. We report the case of a 33-year-old lady with multiple sclerosis who underwent left internal jugular venoplasty resulting in iatrogenic jugular thrombosis requiring open thrombectomy for symptom relief..[null:2011]{Human}
- We aim to present a very rare case of chronic cerebrospinal venous insufficiency due to both brachiocephalic vein obstruction by aberrant right subclavian artery and internal jugular vein distal compression by first cervical vertebra transverse process, demonstrated by multislice computerized tomography in a patient with multiple sclerosis..[Djordje:2012]
- In one case plaques of multiple sclerosis were found in the spinal cord. Those two cases are unusual forms of a diffuse disseminated sclerosis: multiple sclerosis and Schilder's disease are considered as two anatomo-clinical variants of the same pathological process. The observed necrotic lesions are different from the acute necrotic forms of multiple sclerosis as the latter have rapidly developed..[Lhermitte:1982]{Human}
- The prevailing view on multiple sclerosis etiopathogenesis has been challenged by the suggested new entity chronic cerebrospinal venous insufficiency. To test this hypothesis, we studied 21 relapsing-remitting multiple sclerosis cases and 20 healthy controls with phase-contrast magnetic resonance imaging. In addition, in multiple sclerosis cases we performed contrast-enhanced magnetic resonance angiography. We found no differences regarding internal jugular venous outflow, aqueductal cerebrospinal fluid flow, or the presence of internal jugular blood reflux..[Peter:2010]{Human}
- Here, we report on 3 cases with chronic progressive multiple sclerosis who have undergone the pulse-dose cyclophosphamide treatment. The cases included 3 women, two with primary progressive multiple sclerosis (one, the classical form and the other, the spinal cord from). The 3rd case was that of myelitis-optic neuritic form and the total blindness of right eye (left side had been totally blind) was impending despite repeated corticosteroid therapies..[Watanabe:1993]{Human}
- Fifty-four patients, with multiple sclerosis from North-West India are described. This included two pathologically proven cases of multiple sclerosis..[Chopra:1981]{Human}
- The present paper is based on an exact analysis of the neurootological findings in 30 cases of multiple sclerosis (MS)..[Meran:1977]{Human}
- Although the association of a clinical picture resembling multiple sclerosis with ankylosing spondylitis has been reported, there are a few, and sometimes poorly documented, published cases..[Garc?a:1980]{Human}
- The first autopsy of a case of multiple sclerosis from the District of Hokuriku was reported..[Isaki:1980]{Human}
- A case of transitional type of multiple sclerosis with large periventricular cuffs of demyelination is presented..[Pruchnik:1994]{Human}
- Objective: Herein, we report 3 cases of SCH and suggest a possible association with trauma-related neurodegenerative or chronic inflammatory diseases..[Renzo:2011]
- These 3 cases have shown neurological improvements or at least arrest of the progression following the therapy..[Watanabe:1993]{Human}
|
[Significant Different]:0.36149037
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure..[Zamboni:2010]{Human}
- Key Points • Chronic cerebrospinal venous insufficiency is a controversial topic in multiple sclerosis. • Ultrasound assessment of extracranial veins has yielded different results in the literature. • These differences may be due to dependence on Doppler and selection bias. • We found variations in vertebral vein flow in patients with multiple sclerosis..[Fatih:2011]
- Background Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system, believed to be triggered by an autoimmune reaction to myelin. Recently, a fundamentally different pathomechanism termed ' chronic cerebrospinal venous insufficiency' ( CCSVI) was proposed, provoking significant attention in the media and scientific community..[Christoph:2011]
- This study demonstrates that venous outflow disturbances in the form of CCSVI significantly impact on CSF pathophysiology in patients with MS..[Zamboni:2009]{Human}
- Neutral protease activity was significantly elevated in the cerebro-spinal fluid of patients with multiple sclerosis (MS) in exacerbation and in the acute phase of acute viral meningoencephalitis (AME) compared with that of MS in remission, amyotrophic lateral sclerosis or psychosomatic disease..[Inuzuka:1987]{Human}
- The ionophoretic stimulation of granulocytes incubated with thrombocytes caused marked inhibition of leucocyte adherence in healthy controls and to a significantly smaller extent in patients with multiple sclerosis without corticosteroid treatment..[Mayer:1990]{Human}
- All participants underwent ultrasonography (US) to detect signs of CCSVI. CCSVI was detected in 55% of patients in the MS group and 35% in the control group; the difference was not statistically significant (p=0.089). In our experience, a slight difference exists in the prevalence of CCSVI between MS and healthy controls, but it is not as yet clear which parameters may be most significant. This preliminary study failed to show a statistically significant difference in the prevalence of CCSVI among patients affected by MS..[Floris:2012]
- The prevalence of CCSVI was higher in patients with MS than in control subjects (77% vs 28%, P < .0001). CCT was not significantly different between patients with MS who had CCSVI and patients with MS who did not (P = .182)..[Marcello:2012]
- Secondly, it may result in significant hypoperfusion of the brain and spinal cord..[Marian:2012]
- Significant improvement in the clinical state of the patient and a marked increase of the mean alpha frequency in the parietooccipital region could be demonstrated after short intensive immunosuppressive therapy..[Colon:1982]{Human}
- Although our study of the dynamics of TNF-alpha, IL-2, IL-4, IL-6, and IL-10 in vitro production generally found no statistically significant correlations (partly explained by the limited number of values in the various groups), IL-6 was shown to drop during the periods surrounding relapse (P = 0.05) in the absence of treatment, while TNF-alpha (P = 0.04) and IL-6 (P < 0.05) dropped before exacerbation in the presence of AZA..[Schluep:2000]{Human}
- Many reports have been published on these different treatment options, but rarely has a comparison been made between them..[von:2001]{Human}
|
[Symptoms in Patients]:0.3610493
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a hypothesis through which cerebral venous drainage abnormalities contribute towards the pathogenesis of multiple sclerosis. CCSVI venoplasty is already practised worldwide. We report the case of a 33-year-old lady with multiple sclerosis who underwent left internal jugular venoplasty resulting in iatrogenic jugular thrombosis requiring open thrombectomy for symptom relief..[null:2011]{Human}
- In the material of patients with trigeminal neuralgia treated by retrogasserian glycerol injection at the Karolinska Hospital, 23 cases (8%) were also diagnosed as suffering from disseminated sclerosis. These patients were often on carbamazepine treatment before the procedure, a regimen known to cause severe side effects and increase pre-existing symptoms in patients with multiple sclerosis. Following glycerol injection, more than 90% became pain-free within the first 2 months and 82% could discontinue drug therapy. This initial outcome corresponds well to the results in our larger series, but the long-term results in the group with multiple sclerosis is less satisfactory, with 61% recurrence at follow-up 8-79 months following treatment..[Linderoth:1989]{Human}
- Moreover, brain hypoperfusion may lead to chronic fatigue and other global neurologic symptoms. It is hoped that this review will help to elucidate new strategies and treatments for multiple sclerosis and will show new avenues for the research on this debilitating disease..[Marian:2012]
- The analysis of clinical neurological symptoms on the basis of available letters and other documents confirms beyond a doubt the long standing diagnosis of neurosyphilis in the form of chronic meningitis with cranial polyneuritis and wide spread polyradiculitis, formerly called Lues cerebro-spinalis. The symptoms which recurred over 25 years include multiple severe paralysis of cranial nerves, dramatic radicular neuralgias and radicular paralysis in addition to a partial transverse lesion of the spinal cord and terminal coughing and regurgation fits in the absence of symptoms in the cerebrum and brain stem, these symptoms hardly permit different diagnosis. Tuberculosis, lead poisoning, multiple sclerosis or even a myatrophic lateral sclerosis do not explain his neurological symptoms or the cause of his death..[Schiffter:2005]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- Multiple sclerosis is a complex inflammatory disease of the central nervous system that is variable in terms of symptoms and presentation. The objectives of this article are to review briefly the epidemiology and pathophysiology of MS and to focus on the major categories of therapies currently in use to treat MS..[Melody:2009]{Human}
- This focus group, qualitative study (N = 18) reports the psychosocial impact, specifically, of spasticity symptoms on a sample of people with MS ( multiple sclerosis). MS, a chronic disabling disease which attacks the central nervous system, currently affects about 100,000 people in the UK and estimates indicate that worldwide prevalence varies from around 10 to 250 per 100,000..[Nicolson:2011]
- All the patients tolerated the therapy well..[Watanabe:1993]{Human}
- Late onset multiple sclerosis (LOMS), defined as the first presentation of clinical symptoms in patients over 50, is not a rare phenomenon as previously thought, since the prevalence ranges between 4% and 9.6% in different studies..[Martinelli:2005]{Human}
- Fatigue is a frequent symptom in multiple sclerosis (MS) that can interfere with a patient's daily functioning..[Krupp:1988]{Human}
- Ultrasonography after the procedure is recommended to confirm venous patency and to identify patients experiencing acute venous thrombosis..[Kenneth:2012]
|
[Chronic Progressive]:0.33764327
- Although cyclophosphamide pulse therapy has been reported to be beneficial for patients with chronic progressive multiple sclerosis for whom other treatment modalities are not expected to improve outcome, the experience with Japanese patients has not been shown in the literature..[Watanabe:1993]{Human}
- Here, we report on 3 cases with chronic progressive multiple sclerosis who have undergone the pulse-dose cyclophosphamide treatment. The cases included 3 women, two with primary progressive multiple sclerosis (one, the classical form and the other, the spinal cord from). The 3rd case was that of myelitis-optic neuritic form and the total blindness of right eye (left side had been totally blind) was impending despite repeated corticosteroid therapies..[Watanabe:1993]{Human}
- Tumor necrosis factor (TNF) alpha, interleukins (IL) 2, 4, 6, and 10, and IgG oligoclonal bands (IgG OB) in vitro production was assessed, after whole-blood stimulation with lipopolysaccharide or concanavalin A, in 61 patients presenting with relapsing-remitting, relapsing-progressive, or chronic progressive multiple sclerosis. Multiple sclerosis patients were receiving no treatment or azathioprine (AZA), cyclosporin, cyclophosphamide, subcutaneous interferon (IFN) beta 1 a, or corticosteroids (CST)..[Schluep:2000]{Human}
- Multiple sclerosis (MS) is a chronic progressive disease which is the leading cause, after road traffic accidents, of handicap in young subjects..[Donz?:2007]{Human}
- OPINION Multiple sclerosis (MS) is a relapsing and progressive disorder of the central nervous system..[Claudiu:2012]
- Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy..[Renzo:2011]
- A twenty-five year old woman developed a progressive right hemiparesis which remitted within three months, without treatment. The diagnosis was a first relapse of multiple sclerosis..[Confavreux:1994]{Human}
- The study aimed to evaluate neopterin levels in cerebro-spinal fluid (CSF) as a marker of disease activation and progression of multiple sclerosis (MS)..[Tsolaki:2003]
- LOMS is usually associated with a faster progression to disability compared to young adult multiple sclerosis (MS) patients..[Martinelli:2005]{Human}
- The purpose of this Phase I open label clinical study was to monitor CSF anti-MBP in patients with chronic progressive MS subsequent to IV administration of synthetic peptide (sp) MBP82-98 namely DEN(85)VVHFFKNIVTP(96)RT..[Warren:2000]{Human}
- These 3 cases have shown neurological improvements or at least arrest of the progression following the therapy..[Watanabe:1993]{Human}
|
[Suggested Multiple Sclerosis]:0.32179105
- She underwent percutaneous balloon angioplasty of the associated chronic cerebrospinal venous insufficiency ( CCSVI), due to membranous obstruction of the proximal azygous vein, with severe stenosis of the left internal jugular vein. Treatment of the associated CCSVI made a parallel improvement in both clinical and neurophysiological parameters, allowing us to avoid high dose steroid therapy. The relationship between the clinical and neurophysiological course on the one hand, and haemodynamic correction of the associated CCSVI on the other, calls for further exploration on a wider number of patients. The impact of CCSVI on the different neuro-physiological parameters has not been fully estimated, but the intriguing case here reported suggests that it may be greater than previously assumed. The demonstration of a modification of the cerebrovenous function with both clinical manifestation and via TMS suggests that the hampered cerebral venous return may contribute to the clinical course of MS..[Plasmati:2010]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) was recently proposed as a contributing factor in the pathology of multiple sclerosis. This concept has gained remarkable attention, partly because endovascular neurointervention has been suggested as a treatment strategy..[Amer:2011]
- Zamboni et al proposed a new hypothesis for the pathomechanisms of multiple sclerosis (MS): chronic cerebrospinal venous insufficiency ( CCSVI). Using Doppler ultrasound and venograms, they found severe extracranial venous stenosis in MS patients. They suggested that a venous obstruction in the neck caused a reflux back into the brain, which led to edema and demyelination..[Masami:2011]{Human}
- A patient with ankylosing spondylitis developed a neurological disorder suggesting multiple sclerosis. An increased level of gammaglobulin was detected in the analysis of the cerebro spinal fluid. The response to steroid therapy, however, was unusual to that of multiple sclerosis since clinical manifestations disappeared shortly after, recurred some months later after discontinuance of the treatment, and subside again when the administration of corticosteroids was repeated..[Garc?a:1980]{Human}
- Although frequently suggested in the lay press, there is no proven effect in other indications, such as amyotrophic lateral sclerosis, multiple sclerosis and myocardial infarction..[Braat:2006]{Human}
- A new sign of multiple sclerosis, the contracting cord sign, is described. The myelographic demonstration of a large cord that subsequently decreases in size may suggest multiple sclerosis. Multiple sclerosis must be considered in the differential diagnosis of an enlarged spinal cord..[Haughton:1979]{Human}
- This study suggests that a multimodal non-invasive approach (DS and MRV) increases the specificity for a diagnosis of CCSVI in patients with MS..[Dolic:2012]
- The results suggest a change of membrane properties, dependent on thrombocytes, in the early stage of non-specific granulocyte activation in patients with multiple sclerosis..[Mayer:1990]{Human}
- In conclusion, we found no evidence confirming the suggested vascular multiple sclerosis hypothesis..[Peter:2010]{Human}
- Objective: Herein, we report 3 cases of SCH and suggest a possible association with trauma-related neurodegenerative or chronic inflammatory diseases..[Renzo:2011]
|
[Amyotrophic Lateral Sclerosis]:0.2909938
- Minocycline, a commonly prescribed tetracycline antibiotic, has shown promise as a potential therapeutic agent in animal models of numerous neurologic disorders such as amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, Huntington's disease, stroke, and spinal cord injury (SCI)..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- The autopsy showed characteristic "old" plaques of multiple sclerosis in the cerebrum with anterior horn cell and pyramidal tracts degeneration, typical of amyotrophic lateral sclerosis, in the spinal cord. Although exceptional, this association of amyotrophic lateral sclerosis and multiple sclerosis leads to the discussion of an etiological immunological dysregulation common to these two diseases..[Confavreux:1994]{Human}
- Cerebrospinal fluid analysis was consistent with multiple sclerosis. The patient died of respiratory failure two years after presentation, and autopsy revealed multifocal demyelination involving the corpus callosum, cerebellum and spinal cord as well as pathologic findings typical of amyotrophic lateral sclerosis. A review of the literature confirms the exceedingly unusual combination of amyotrophic lateral sclerosis with multiple sclerosis..[Dynes:2001]{Human}
- Although frequently suggested in the lay press, there is no proven effect in other indications, such as amyotrophic lateral sclerosis, multiple sclerosis and myocardial infarction..[Braat:2006]{Human}
- Conclusions: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis..[Renzo:2011]
- Neutral protease activity was significantly elevated in the cerebro-spinal fluid of patients with multiple sclerosis (MS) in exacerbation and in the acute phase of acute viral meningoencephalitis (AME) compared with that of MS in remission, amyotrophic lateral sclerosis or psychosomatic disease..[Inuzuka:1987]{Human}
- Two of them presented with concomitant, relatively rare disabling neurological diseases, namely amyotrophic lateral sclerosis and multiple sclerosis..[Renzo:2011]
- Loss of neurons due to cell death and axonal degeneration characterize neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease or amyotrophic lateral sclerosis..[Zipp:2011]{Human}
|
[Partial Effects]:0.29046464
- PTA seems to be an effective treatment for patients with CCVI and multiple sclerosis, However, randomized studies are warranted to establish the efficacy of this new treatment for MS..[Kipshidze:2011]
- Although frequently suggested in the lay press, there is no proven effect in other indications, such as amyotrophic lateral sclerosis, multiple sclerosis and myocardial infarction..[Braat:2006]{Human}
- In conclusion the B cell tolerizing effect of spMBP82-98 segregated into four kinetic profiles; this molecular variability should be considered in attempts to develop specific 'peptide therapies' for the broad range of clinical profiles currently diagnosed as ' multiple sclerosis'. Multiple Sclerosis (2000) 6 300 - 311.[Warren:2000]{Human}
- Currently available disease-modifying therapies (DMTs) are known to be only partially effective in adults with multiple sclerosis (MS)..[Ann:2010]
- Spinal cord MRI may provide information about disease progression that is not readily available from brain MRI scans and could be useful in diagnosing MS in some cases, as well as for monitoring the effects of treatments..[Christopher:2005]{Human}
- Although switching between first-line DMTs may be effective in pediatric patients with disease that is refractory to initial treatment, a subset of patients may require second-line therapeutic interventions..[Ann:2010]
- A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined..[Barlow:2010]{Human}
- Atrophy should now be included as a secondary endpoint in trials of therapies aimed at limiting disease progression. Currently available anti-inflammatory immunomodulatory agents and immunosuppressive treatments, while effective at preventing clinical deterioration, have shown at best partial effects in preventing CNS atrophy. Thus, there is a need to further validate atrophy as an outcome measure and ultimately develop treatment strategies that will protect against the destructive aspects of the disease process..[Robert:2004]{Human}
- In patients with disseminated sclerosis and in a control group inhibition of granulocyte adherence was investigated after stimulation with the ionophore A23187 and the effect of autologous thrombocytes on this reactivity was investigated..[Mayer:1990]{Human}
|
[MS Patients]:0.2686609
- The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed..[Jacek:2011]{Human}
- Although cyclophosphamide pulse therapy has been reported to be beneficial for patients with chronic progressive multiple sclerosis for whom other treatment modalities are not expected to improve outcome, the experience with Japanese patients has not been shown in the literature..[Watanabe:1993]{Human}
- The medical situations associated with an increased risk of thrombosis which are well documented are cancer, myocardial infarction, cardiac insufficiency, ischemic cerebro-vascular accidents with paralysis of lower limb(s), acute respiratory insufficiency in patients admitted to intensive care unit, prolonged immobilisation in elderly invalid patients and paralysis of the limbs due to spinal trauma. Prophylactic treatment in medical patients is still empirical..[Samama:1996]{Human}
- Tumor necrosis factor (TNF) alpha, interleukins (IL) 2, 4, 6, and 10, and IgG oligoclonal bands (IgG OB) in vitro production was assessed, after whole-blood stimulation with lipopolysaccharide or concanavalin A, in 61 patients presenting with relapsing-remitting, relapsing-progressive, or chronic progressive multiple sclerosis. Multiple sclerosis patients were receiving no treatment or azathioprine (AZA), cyclosporin, cyclophosphamide, subcutaneous interferon (IFN) beta 1 a, or corticosteroids (CST)..[Schluep:2000]{Human}
- Although switching between first-line DMTs may be effective in pediatric patients with disease that is refractory to initial treatment, a subset of patients may require second-line therapeutic interventions..[Ann:2010]
- The prevalence of CCSVI was higher in patients with MS than in control subjects (77% vs 28%, P < .0001). CCT was not significantly different between patients with MS who had CCSVI and patients with MS who did not (P = .182)..[Marcello:2012]
- In the future, rehabilitation professionals will have to learn how to anticipate patient needs and lay the groundwork for services and equipment in advance. Rehabilitation is one of the treatments of MS patients and should be viewed as an ongoing process to maintain and restore maximum function and quality of life..[Donz?:2007]{Human}
- T-cell clones derived from the CSF (cerebrospinal fluid) of MS ( multiple sclerosis) patients have been analysed for the production of interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-4 (IL-4). Each CSF-T clone (both CD4+ and CD8+) produced substantial amounts of IFN-gamma and especially TNF-alpha compared with autologous peripheral T clones and liver-infiltrating T clones from patients with chronic active hepatitis..[Buttinelli:1994]{Human}
- All the patients tolerated the therapy well..[Watanabe:1993]{Human}
- Fatigue is a frequent symptom in multiple sclerosis (MS) that can interfere with a patient's daily functioning..[Krupp:1988]{Human}
- Ultrasonography after the procedure is recommended to confirm venous patency and to identify patients experiencing acute venous thrombosis..[Kenneth:2012]
|
[Results]:0.26800275
- The hypothesis proposes mechanisms by which an infective venous vasculitis could result in the specific neural damage, metabolic, immunological and vascular effects observed in MS. The hypothesis described is consistent with many of the known facts of MS pathogenesis and therefore provides a framework for further research into a venous aetiology for the disease.If MS does result from a chronic infective venulitis rather than a syndrome involving congenital truncular venous malformations, then additional therapies to the currently used angioplasties will be required to optimize results..[Thibault:2012]
- Key Points • Chronic cerebrospinal venous insufficiency is a controversial topic in multiple sclerosis. • Ultrasound assessment of extracranial veins has yielded different results in the literature. • These differences may be due to dependence on Doppler and selection bias. • We found variations in vertebral vein flow in patients with multiple sclerosis..[Fatih:2011]
- The treatment is called "liberation treatment," and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment..[Reekers:2011]
- In the material of patients with trigeminal neuralgia treated by retrogasserian glycerol injection at the Karolinska Hospital, 23 cases (8%) were also diagnosed as suffering from disseminated sclerosis. These patients were often on carbamazepine treatment before the procedure, a regimen known to cause severe side effects and increase pre-existing symptoms in patients with multiple sclerosis. Following glycerol injection, more than 90% became pain-free within the first 2 months and 82% could discontinue drug therapy. This initial outcome corresponds well to the results in our larger series, but the long-term results in the group with multiple sclerosis is less satisfactory, with 61% recurrence at follow-up 8-79 months following treatment..[Linderoth:1989]{Human}
- In conclusion, we can state that the result of endovascular treatment seems to decay although the baseline is still higher than preoperative..[Beelen:2012]
- Our main conclusion is that, given the results we currently have available, we should be cautious and, for the time being, it would be advisable not to recommend the systematic use of this treatment for our patients..[Carmen:2011]
- The results suggest a change of membrane properties, dependent on thrombocytes, in the early stage of non-specific granulocyte activation in patients with multiple sclerosis..[Mayer:1990]{Human}
- Secondly, it may result in significant hypoperfusion of the brain and spinal cord..[Marian:2012]
|
[Status of Currently]:0.220559
- Currently, there is inconclusive evidence to support CCSVI as an etiological factor in patients with multiple sclerosis..[Amer:2011]
- Further interest has been generated by the idea of chronic cerebrospinal venous insufficiency that might be associated with brain iron accumulation due to a reduction in venous outflow, but its existence and etiologic role in MS are currently controversially debated..[Michael:2011]
- This is an attempt to review the status of current therapy and future prospects in the treatment of MS..[Khan:1996]{Human}
- The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment..[Reekers:2011]
- This review discusses the status of current and future therapy in the treatment of MS. Multiple sclerosis (MS) is the most common demyelinating disease of the human central nervous system (CNS)..[Khan:1996]{Human}
- In conclusion the B cell tolerizing effect of spMBP82-98 segregated into four kinetic profiles; this molecular variability should be considered in attempts to develop specific 'peptide therapies' for the broad range of clinical profiles currently diagnosed as ' multiple sclerosis'. Multiple Sclerosis (2000) 6 300 - 311.[Warren:2000]{Human}
- Currently available disease-modifying therapies (DMTs) are known to be only partially effective in adults with multiple sclerosis (MS)..[Ann:2010]
- Our main conclusion is that, given the results we currently have available, we should be cautious and, for the time being, it would be advisable not to recommend the systematic use of this treatment for our patients..[Carmen:2011]
|
[Including Multiple]:0.20493555
- Azathioprine is an immunosuppressive drug widely used in the treatment of chronic inflammatory diseases, including Multiple Sclerosis (MS). We report two patients who developed the first manifestations of clinically definite multiple sclerosis while on long term (3.5 and 10 years, respectively) treatment with azathioprine for Crohn's disease..[Constantinescu:2000]{Human}
- Here, we report on 3 cases with chronic progressive multiple sclerosis who have undergone the pulse-dose cyclophosphamide treatment. The cases included 3 women, two with primary progressive multiple sclerosis (one, the classical form and the other, the spinal cord from). The 3rd case was that of myelitis-optic neuritic form and the total blindness of right eye (left side had been totally blind) was impending despite repeated corticosteroid therapies..[Watanabe:1993]{Human}
- Spasticity occurs in children and adults due to a wide range of conditions, including cerebral palsy, head and spinal cord trauma, cerebrovascular accidents and multiple sclerosis. Multiple treatment options have been described, including medical and surgical treatments..[von:2001]{Human}
- Fifty-four patients, with multiple sclerosis from North-West India are described. This included two pathologically proven cases of multiple sclerosis..[Chopra:1981]{Human}
- A growing body of evidence indicates that irreversible tissue destruction including axonal and neuronal degeneration is a key component of the multiple sclerosis (MS) disease process. Magnetic resonance imaging (MRI) is a powerful technique that can be combined with semiautomated or automated computer assisted analysis approaches to detect progressive atrophy of the brain and spinal cord with high sensitivity and reproducibility. The pathophysiology of central nervous system (CNS) atrophy in MS is unknown but likely represents an epiphenomenon related to the effects of inflammation including chronic demyelination, axonal injury, neuronal loss and Wallerian degeneration..[Robert:2004]{Human}
- Emerging therapies are rapidly expanding treatment options, including both parenterally administered and oral medications..[Daniel:2012]
- No distribution of these bands, particularly in the more cathodal zone, seems to be specific of any disease including multiple sclerosis (M.S.)..[Confavreux:1982]{Human}
|
[Condition]:0.20106173
- The condition was named chronic cerebrospinal venous insufficiency ( CCSVI)..[Yára:2011]{Human}
- The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed..[Jacek:2011]{Human}
- An analysis was performed of features of incipient manifestations of multiple sclerosis in 648 patients with a primary diagnosis having been made at the Ukrainian Centre for Study of Demyelinating Diseases over 1992-1996. Incipient manifestations of disseminated sclerosis revealed themselves predominantly as sensory, motor, visual, and coordination impairment against the background of pain sensations, paresthesias and pronounced asthenia of the nervous system. Knowledge of disseminated sclerosis debut is important for the diagnosis of the condition to be made and treatments to be administered in a timely fashion..[Vinychuk:1998]{Human}
- Spasticity occurs in children and adults due to a wide range of conditions, including cerebral palsy, head and spinal cord trauma, cerebrovascular accidents and multiple sclerosis. Multiple treatment options have been described, including medical and surgical treatments..[von:2001]{Human}
- Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy..[Renzo:2011]
- A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined..[Barlow:2010]{Human}
- Multiple sclerosis (MS) is a chronic neurological condition characterized pathologically by axonal loss, demyelination, inflammation, and gliosis. Magnetic resonance imaging (MRI) has had a major impact on diagnosing MS, understanding the condition, and monitoring the effects of treatments. Recently, spinal cord MRI has received increased attention. Advanced techniques have been used to image the spinal cord, particularly the cervical cord, and measure quantitative parameters such as T1 relaxation time, magnetization transfer ratio, and diffusivity..[Christopher:2005]{Human}
|
[Studies Aim to Evaluate]:0.18726957
- This study aimed to evaluate the prevalence of chronic cerebrospinal venous insufficiency ( CCSVI) in patients with multiple sclerosis (MS)..[Floris:2012]
- Recent reports have emerged suggesting that multiple sclerosis (MS) may be due to abnormal venous outflow from the central nervous system, termed chronic cerebrospinal venous insufficiency ( CCSVI). These reports have generated strong interest and controversy over the prospect of a treatable cause of this chronic debilitating disease. This review aims to describe the proposed association between CCSVI and MS, summarize the current data, and discuss the role of endovascular therapy and the need for rigorous randomized clinical trials to evaluate this association and treatment..[Marc:2011]
- Chronic cerebrospinal venous insufficiency ( CCSVI) represents a recently described condition that may potentially contribute to the symptoms experienced by patients with multiple sclerosis. The evaluation of a prospective patient for CCSVI often involves an invasive evaluation with venography of the internal jugular and azygos veins. The purpose of this article is to review the normal anatomy of the internal jugular, vertebral, and azygos veins, as an understanding of these veins is necessary for appropriate interpretation of the venograms obtained to evaluate patients for CCSVI..[John:2011]
- Recent clinical studies have suggested a relationship between multiple sclerosis (MS) and the occurrence of pathological changes in the jugular, vertebral and azygous veins that result in abnormal blood outflow from the brain and the spinal cord. Together, these pathological changes have been designated chronic cerebrospinal venous insufficiency ( CCSVI). The aim of the present study was to evaluate the usefulness of duplex Doppler ultrasound in the evaluation of central nervous system venous outflow disturbances in patients suffering from MS..[Zaniewski:2012]
- The diagnostic value of CSF oligoclonal IgG bands, intrathecal IgG synthesis, cytology and markers of myelin breakdown in the cerebro-spinal fluid were evaluated in multiple sclerosis..[Schmidt:1987]{Human}
- The study aimed to evaluate neopterin levels in cerebro-spinal fluid (CSF) as a marker of disease activation and progression of multiple sclerosis (MS)..[Tsolaki:2003]
- As both drugs have translational potential, we evaluated their neuroprotective properties here in a clinically relevant model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
|
[New Venous]:0.18594897
- A new nosologic vascular pattern that is defined by chronic cerebrospinal venous insufficiency ( CCSVI) has been strongly associated with multiple sclerosis..[Paolo:2009]{Human}
- Zamboni et al proposed a new hypothesis for the pathomechanisms of multiple sclerosis (MS): chronic cerebrospinal venous insufficiency ( CCSVI). Using Doppler ultrasound and venograms, they found severe extracranial venous stenosis in MS patients. They suggested that a venous obstruction in the neck caused a reflux back into the brain, which led to edema and demyelination..[Masami:2011]{Human}
- PTA seems to be an effective treatment for patients with CCVI and multiple sclerosis, However, randomized studies are warranted to establish the efficacy of this new treatment for MS..[Kipshidze:2011]
- Although comparing these new drugs with available therapies is difficult, they do show promise as potential first-line agents for the treatment of multiple sclerosis. This marks a new frontier in the treatment of this disease, as the advent of new oral drugs will lead to increased patient compliance and contribute to longer sustained symptom-free periods and less marked disability..[Kristen:2010]{Human}
- A new sign of multiple sclerosis, the contracting cord sign, is described. The myelographic demonstration of a large cord that subsequently decreases in size may suggest multiple sclerosis. Multiple sclerosis must be considered in the differential diagnosis of an enlarged spinal cord..[Haughton:1979]{Human}
- Moreover, brain hypoperfusion may lead to chronic fatigue and other global neurologic symptoms. It is hoped that this review will help to elucidate new strategies and treatments for multiple sclerosis and will show new avenues for the research on this debilitating disease..[Marian:2012]
- The authors present a new technique for the analysis of the cerebro spinal fluid (C.S.F.) proteins: silver stain after isoelectric focusing with possibility of immunofixation..[Confavreux:1982]{Human}
|
[Intracranial Pressure]:0.18163973
- Currently, the hypothesis that altered venous hemodynamics might play a causative role in the pathogenesis of multiple sclerosis (MS) is being controversially discussed. This new " venous hypothesis" postulates that obstructions of the cervical venous system cause an increased pressure of the intracranial venous system and that in turn intracranial congestion disintegrates the blood-brain barrier initiating the inflammatory process in MS.The " venous hypothesis" is analyzed and evaluated with regard to the following aspects: first concerning the validity of published data, second with regard to the plausibility in view of the currently approved pathogenetic model of MS, and third with regard to the compatibility with preliminary neurosonological findings in a small but unselected cohort of patients at our department.The authors conclude that the " chronic cerebrospinal venous insufficiency ( CCSVI)" cannot represent the exclusive pathogenetic factor in the pathogenesis of MS. In our cohort, only 20% of the patients fulfilled the required neurosonological features of CCSVI..[Krogias:2010]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) has been postulated as a cause for multiple sclerosis (MS). Venous pressure assessments have not been made. Intracranial venous pressure was assessed using ophthalmodynamometry in 29 MS patients and compared with 28 healthy controls and 19 cases with elevated intracranial pressure (ICP). MS and control subjects had normal venous pressures (mean 15.5 resp. 15.1 cmHg). Only cases with intracranial pressure pathology had elevated venous pressures (mean 28.8 cmHg). There is no evidence of an increased intracranial venous pressure in MS patients..[Rolf:2011]
- To the contrary, substitute circles are alternative pathways or vicarious venous shunts, which permit the drainage and prevent intracranial hypertension. In accordance with the pattern of obstruction, even the intracranial and the intrarachidian veins can also become substitute circles; they permit redirection of the deviated flow, piping the blood toward available venous segments outside the central nervous system. We review the complex gross and radiological anatomy of collateral circulation found activated by the means of EchoColor-Doppler and selective venography in the event of CCSVI, focusing particularly on the suboccipital cavernous sinus (SCS), the condylar venous system, the pterygoid plexus, the thyroid veins, and the emiazygous-lumbar venous anastomosis with the left renal vein..[Paolo:2009]{Human}
- Extra- and intracranial venous flow direction was assessed by colour-coded duplex sonography, and extracranial venous cross-sectional area (VCSA) of the internal jugular and vertebral veins (IJV/VV) was measured in B-mode to assess the five previously proposed CCSVI criteria..[Christoph:2011]
|
[Investigated]:0.16932207
- TMS supports the diagnosis of MS, detecting corticospinal tract involvement and monitoring its course with or without treatment. It has been never investigated whether any relationship exists between the TMS outcome measure and minimally invasive treatment of multiple severe extracranial stenosis, affecting the principal ce rebrospinal venous segments in MS patients..[Plasmati:2010]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a vascular picture that shows a strong association with multiple sclerosis (MS). The aim of this study was to investigate the relationship between a Doppler cerebral venous hemodynamic insufficiency severity score (VHISS) and cerebrospinal fluid (CSF) flow dynamics in 16 patients presenting with CCSVI and relapsing-remitting MS (CCSVI-MS) and in eight healthy controls (HCs)..[Zamboni:2009]{Human}
- To investigate the differences between multiple sclerosis (MS) and control subjects by using extracranial venous grey-scale, colour and spectral Doppler ultrasound..[Fatih:2011]
- In this Point of View, we discuss the recent investigations that led to the description of CCSVI as well as the conceptual and technical shortcomings that challenge the potential relationship of this phenomenon to MS..[Omar:2010]{Human}
- Detection frequency of human herpesvirus 6 (HHV-6) and Epstein Barr virus (EBV) DNA in multiple sclerosis (MS) patients and controls was investigated..[Hay:2000]{Human}
- In patients with disseminated sclerosis and in a control group inhibition of granulocyte adherence was investigated after stimulation with the ionophore A23187 and the effect of autologous thrombocytes on this reactivity was investigated..[Mayer:1990]{Human}
|
[Magnetic Resonance Imaging MRI]:0.15473741
- The aim of this study was to investigate whether a combination of Doppler sonography (DS) and magnetic resonance venography (MRV) on 3T MRI increases specificity for detection of chronic cerebrospinal venous insufficiency ( CCSVI) in 171 (113 relapsing-remitting, 47 secondary-progressive, 11 primary progressive) patients with multiple sclerosis (MS) and 79 age- and sexmatched healthy controls (HCs). One hundred ten (64.3%) MS patients and 30 (38%) HCs presented ≥2 venous hemodynamic CCSVI criteria (p<.0001). Both DS and MRV showed relatively high specificity but lower sensitivity for determining a CCSVI diagnosis in patients with MS vs HCs and between MS subgroups..[Dolic:2012]
- The prevailing view on multiple sclerosis etiopathogenesis has been challenged by the suggested new entity chronic cerebrospinal venous insufficiency. To test this hypothesis, we studied 21 relapsing-remitting multiple sclerosis cases and 20 healthy controls with phase-contrast magnetic resonance imaging. In addition, in multiple sclerosis cases we performed contrast-enhanced magnetic resonance angiography. We found no differences regarding internal jugular venous outflow, aqueductal cerebrospinal fluid flow, or the presence of internal jugular blood reflux..[Peter:2010]{Human}
- Multiple sclerosis (MS) is a disease of the white matter. Magnetic resonance imaging (MRI) is proven to be a sensitive method of monitoring the progression of this disease and of its changes due to treatment protocols. Quantification of the severity of the disease through estimation of MS lesion volume via MR imaging is vital for understanding and monitoring the disease and its treatment..[Udupa:1997]{Human}
- Spinal cord MRI may provide information about disease progression that is not readily available from brain MRI scans and could be useful in diagnosing MS in some cases, as well as for monitoring the effects of treatments..[Christopher:2005]{Human}
- A growing body of evidence indicates that irreversible tissue destruction including axonal and neuronal degeneration is a key component of the multiple sclerosis (MS) disease process. Magnetic resonance imaging (MRI) is a powerful technique that can be combined with semiautomated or automated computer assisted analysis approaches to detect progressive atrophy of the brain and spinal cord with high sensitivity and reproducibility. The pathophysiology of central nervous system (CNS) atrophy in MS is unknown but likely represents an epiphenomenon related to the effects of inflammation including chronic demyelination, axonal injury, neuronal loss and Wallerian degeneration..[Robert:2004]{Human}
- Multiple sclerosis (MS) is a chronic neurological condition characterized pathologically by axonal loss, demyelination, inflammation, and gliosis. Magnetic resonance imaging (MRI) has had a major impact on diagnosing MS, understanding the condition, and monitoring the effects of treatments. Recently, spinal cord MRI has received increased attention. Advanced techniques have been used to image the spinal cord, particularly the cervical cord, and measure quantitative parameters such as T1 relaxation time, magnetization transfer ratio, and diffusivity..[Christopher:2005]{Human}
- Despite the technical difficulties of performing spinal cord MRI, imaging studies, particularly of the cervical cord, are becoming more common..[Christopher:2005]{Human}
|
[White Matter]:0.14820153
- Concepts of multiple sclerosis (MS) have shifted from the traditional view of a T cell-mediated, demyelinating disease of the white matter to include a broad range of immunopathogenic mechanisms, axonal damage, and widespread gray matter pathology. The cause of MS remains unknown, but recent epidemiological work has focused on genetic factors; environmental factors such as vitamin D, sunlight, and Epstein-Barr virus; and the controversial theory of chronic cerebrospinal venous insufficiency..[Daniel:2012]
- Multiple sclerosis (MS) is a disease of the white matter. Magnetic resonance imaging (MRI) is proven to be a sensitive method of monitoring the progression of this disease and of its changes due to treatment protocols. Quantification of the severity of the disease through estimation of MS lesion volume via MR imaging is vital for understanding and monitoring the disease and its treatment..[Udupa:1997]{Human}
- The corticospinal and rubrospinal tracts were traced and the spinal cords were harvested 7 weeks after injury. The extent of gray matter and white matter sparing and corticospinal and rubrospinal tract sprouting were evaluated in cross sections of the spinal cord. In the end, neither minocycline nor simvastatin treatment was associated with improved performance on the behavioral tests, as compared to saline controls..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
- The aim of this study was to simultaneously measure in vivo volumes of gray matter (GM), normal white matter (WM), abnormal white matter (aWM), and cerebro-spinal fluid (CSF), and to assess their relationship in 50 patients with relapsing-remitting multiple sclerosis (RR-MS) (age range, 21-59; mean EDSS, 2.5; mean disease duration, 9.9 years), using an unsupervised multiparametric segmentation procedure applied to brain MR studies..[Mario:2003]{Human}
- Nineteen months after the original publication on CCSVI and MS, another 22 papers have been published addressing the matter..[Yára:2011]{Human}
|
[Drug]:0.14063334
- Azathioprine is an immunosuppressive drug widely used in the treatment of chronic inflammatory diseases, including Multiple Sclerosis (MS). We report two patients who developed the first manifestations of clinically definite multiple sclerosis while on long term (3.5 and 10 years, respectively) treatment with azathioprine for Crohn's disease..[Constantinescu:2000]{Human}
- Although comparing these new drugs with available therapies is difficult, they do show promise as potential first-line agents for the treatment of multiple sclerosis. This marks a new frontier in the treatment of this disease, as the advent of new oral drugs will lead to increased patient compliance and contribute to longer sustained symptom-free periods and less marked disability..[Kristen:2010]{Human}
- In the material of patients with trigeminal neuralgia treated by retrogasserian glycerol injection at the Karolinska Hospital, 23 cases (8%) were also diagnosed as suffering from disseminated sclerosis. These patients were often on carbamazepine treatment before the procedure, a regimen known to cause severe side effects and increase pre-existing symptoms in patients with multiple sclerosis. Following glycerol injection, more than 90% became pain-free within the first 2 months and 82% could discontinue drug therapy. This initial outcome corresponds well to the results in our larger series, but the long-term results in the group with multiple sclerosis is less satisfactory, with 61% recurrence at follow-up 8-79 months following treatment..[Linderoth:1989]{Human}
- Interferon beta-1b (Betaseron), a drug that affects the natural course of the disease, was developed for the treatment of relapsing-remitting MS. Multiple Sclerosis Pathways (MSP), a disease management program, was developed to provide comprehensive and personal support to MS patients taking interferon beta-1b and to serve as an information resource for all people with MS, their families, and healthcare professionals..[Madonna:2000]{Human}
- In 1993, Food and Drug Administration (FDA) approved Betaseron for the treatment of MS. Todate, this is the only drug approved by the FDA, specifically for the treatment of MS..[Khan:1996]{Human}
- As both drugs have translational potential, we evaluated their neuroprotective properties here in a clinically relevant model of contusive cervical spinal cord injury..[Jae:2010]{Non-Human,Non-Trail,Non-Review,Non-Guidline}
|
[Published]:0.110488415
- In 1868 Jean-Martin Charcot's clinicopathological correlation of multiple sclerosis (MS) was published..[Frith:1989]{Human}
- Although the association of a clinical picture resembling multiple sclerosis with ankylosing spondylitis has been reported, there are a few, and sometimes poorly documented, published cases..[Garc?a:1980]{Human}
- Nineteen months after the original publication on CCSVI and MS, another 22 papers have been published addressing the matter..[Yára:2011]{Human}
- Many reports have been published on these different treatment options, but rarely has a comparison been made between them..[von:2001]{Human}
|
[(Other)]:1.001358E-5
- The truncular venous malformation (VM) represents an embryologically defective vein where developmental arrest has occurred during the vascular trunk formation period in the 'later stage' of the embryonic development. A relatively simple truncular VM lesion such as a venous web at the hepatic venous outlet causes portal hypertension giving a profound damage/impact to the liver. A similar condition involving the head and neck venous system may cause chronic cerebro-spinal venous insufficiency ( CCSVI) and may be involved in the development or exacerbation of multiple sclerosis..[Lee:2010]{Human}
- Multiple sclerosis (MS) is an inflammatory demyelinating disease of the CNS caused by the interplay of genetic and environmental factors. In the last years, it has been suggested that an abnormal venous drainage due to stenosis or malformation of the internal jugular and/or azygous veins may play a major pathogenetic role in MS. This abnormality called chronic cerebro-spinal venous insufficiency ( CCSVI) could result in increased permeability of blood brain barrier, local iron deposition and secondary multifocal inflammation..[Ghezzi:2011]{Human}
- The Chronic Cerebro-Spinal Venous Insufficiency, recently described as a possible role in Multiple Sclerosis pathogenesis, is diagnosed and classified with Echo Color Doppler (ECD) examination of the extra- and intra-cranial veins..[Maria:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) was recently described in multiple sclerosis patients. CCSVI is characterized by impaired brain venous drainage due to outflow obstruction in the extracranial venous system, mostly related to anomalies in the internal jugular and azygos veins. The current CCSVI diagnosis is based on Doppler sonography of extracranial and transcranial venous hemodynamics criteria. To date, prevalence estimates of CCSVI, provided by different groups using various imaging methods of assessment, vary widely from none to 100%. There is an urgent need to define and validate the spectrum of cranial/extracranial venous anomalies and to establish reliable, diagnostic gold-standard test(s). The potential usefulness of endovascular treatment for CCSVI in multiple sclerosis patients is still unknown..[Robert:2011]{Human}
- A great variability of CCSVI has been found in both MS patients (ranging from 0 to 100%) and in control subjects (from 0 to 23%). This large variability is explained by methodological aspects, problems in assessing CCSVI, and differences among clinical series. It is urgent to perform appropriate epidemiological studies to define the possible relationship between CCSVI and MS..[Ghezzi:2011]{Human}
- Chronic impaired venous outflow from the central nervous system has recently been claimed to be associated with multiple sclerosis (MS) pathology. This resulted in the term chronic cerebrospinal venous insufficiency ( CCSVI) in MS. The concept of CCSVI is based on sonography studies showing that impaired venous outflow leading to pathological reflux is almost exclusively present in MS patients but not in healthy controls. Based on these findings, a new pathophysiological concept has been introduced suggesting that chronic venous outflow obstruction and venous reflux in the CNS result in pathological iron depositions leading to inflammation and neurodegeneration. The theory of CCSVI in MS has rapidly generated tremendous interest in the media and among patients and the scientific community. In particular, the potential shift in treatment concepts possibly leading to an interventional treatment approach including balloon angioplasty and venous stent placement is currently being debated. However, results from recent studies involving several imaging modalities have raised substantial concerns regarding the CCSVI concept in MS. In this review article, we explain the concept of CCSVI in MS and discuss this hypothesis in the context of MS pathophysiology and imaging studies which have tried to reproduce or refute this theory. In addition, we draw some major conclusions focusing in particular on the crucial question as to whether interventional treatment options are expedient. In conclusion, the present conclusive data confuting the theory of CCSVI in MS should lead to reluctance with respect to the interventional treatment of possible venous anomalies in MS patients..[Wattjes:2011]{Human}
- The aetiology proposed for the development of chronic cerebrospinal venous insufficiency ( CCSVI) associated with multiple sclerosis (MS) has been the presence of congenital truncular venous malformations. However, this hypothesis is not consistent with the epidemiology or geographical incidence of MS and is not consistent with many of the ultrasonographic or radiographical findings of the venous disturbances found in MS patients. However, the probability of a venous aetiology of MS remains strong based on evidence accumulated from the time the disorder was first described.The method used in this review was to search PubMed for all past medical publications related to vascular, venous, haematological, epidemiological, biochemical, and genetic investigations and treatments of MS.Epidemiological and geographical findings of prevalence of MS indicate the involvement of an infective agent. This review of the venous pathology associated with MS describes a hypothesis that the pathogenesis of the venous disease could be initiated by a respiratory infective agent such as Chlamydophila pneumonia, which causes a specific chronic persistent venulitis affecting the cerebrospinal venous system..[Thibault:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the " venous hemodynamic insufficiency severity score" (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits [2]. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints..[Reekers:2011]
- However, the recent description of chronic cerebrospinal venous insufficiency ( CCSVI) associated to MS, with significant anomalies in cerebral venous outflow hemodynamics, permit to propose a parallel with chronic venous disorders (CVDs) in the mechanism of iron deposition. Abnormal cerebral venous reflux is peculiar to MS, and was not found in a miscellaneous of patients affected by other neurodegenerative disorders characterized by iron stores, such as Parkinson's, Alzheimer's, amyotrophic lateral sclerosis. Several recently published studies support the hypothesis that MS progresses along the venous vasculature. The peculiarity of CCSVI-related cerebral venous blood flow disturbances, together with the histology of the perivenous spaces and recent findings from advanced magnetic resonance imaging techniques, support the hypothesis that iron deposits in MS are a consequence of altered cerebral venous return and chronic insufficient venous drainage..[Ajay:2009]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Ultrasound and venographic studies of the internal jugular and azygos venous systems in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 71%, range 0-100%; n=1336) associated with activation of collaterals..[Nicolaides:2012]
- A new venous disorder, chronic cerebrospinal venous insufficiency ( CCSVI), has been proposed in patients with multiple sclerosis (MS). It is a vascular condition characterized by an impaired cerebrospinal venous drainage due to obstructions in the main extracranial cerebrovenous outflow routes (i.e. internal jugular veins [IJV] and/or azygos veins). In this review, the studies which assessed the prevalence of CCSVI in MS by echo colour Doppler (ECD) will be discussed. The technical aspects of determination of the five CCSVI criteria: (1) reflux in the IJV and/or vertebral veins in supine and upright position, (2) reflux in the deep cerebral veins, (3) high-resolution B-mode proximal IJV stenosis, (4) flow not Doppler detectable in IJVs and/or vertebral veins (VVs) and (5) reverted postural control of the main cerebrovenous outflow pathway are described in detail. We conclude that so far there are many studies with contradictory results, and as yet a strong scientific base to support the evidence for a causative relationship of CCSVI and MS is lacking. Recent studies call into question the validity of using ECD as a proper and reliable test for the diagnosis of CCSVI. One explanation for the variety in interpretation of the individual CCSVI criteria, with the wide-ranging percentages CCSVI, could be the different methods by using ECD to determine various criteria..[Van:2012]
- Third, the pathology of MS might be the consequence of a chronic state of impaired venous drainage from the CNS, for which the term chronic cerebrospinal venous insufficiency ( CCSVI) has been coined. A number of recent vascular studies do not support the CCSVI theory, but some elements of CCSVI might be explained by slower cerebral venous blood flow secondary to the reduced cerebral perfusion in patients with MS compared with healthy individuals..[Miguel:2011]{Human}
- Recent work has raised the possibility that MS is not caused primarily by an immune abnormality but may instead arise from venous anomalies affecting the jugular and/or azygos venous systems. This condition has been called chronic cerebrospinal venous insufficiency ( CCSVI). It has been proposed that CCSVI may be pathogenic in MS, causing venous back pressure and iron deposition, with a secondary immune response. Some investigators have proceeded to unblinded nonrandomized angioplasty and stenting procedures in patients with CCSVI, with anecdotal reports of symptom improvement. Because of conflicting data on the presence of CCSVI and the absence of controlled trials of CCSVI intervention, the current standard of clinical care is neither to evaluate multiple sclerosis (MS) patients for CCSVI anomalies, nor to intervene with procedures to alter such anomalies. There is intense interest and ongoing work to evaluate the presence of venous anomalies in MS patients as well as in normal controls and patients with other neurologic conditions; to characterize such anomalies, if present; and to further understand whether the concept of a "backpressure" pathology is borne out by the evidence. If CCSVI is indeed a pathogenic mechanism for some subset of the MS population, this would dramatically change the focus of attention for therapeutic endeavors and monitoring for this population and would bring MS therapeutics firmly into the area of vascular intervention..[Claudiu:2012]
- Multiple sclerosis (MS) is a chronic disease of the central nervous system with not yet completely understood pathogenesis. The so called " chronic cerebrospinal venous insufficiency ( CCSVI) theory" has recently emerged, supporting the concept of a cerebrospinal venous drainage impairment as the cause of MS. Since the first publication on this topic with a claimed 100% specificity and sensitivity of the condition for MS diagnosis, CCSVI theory has generated a scientific and mass media debate with a great hope for the miracle of a new possible endovascular treatment of MS ("liberation procedure"). We critically summarize the available evidence on CCSVI discussing inconsistent and incomplete replication of the original results by different groups, methodological limitations and potential therapeutic implications. We conclude that the available data are insufficient to establish conclusively a clear relationship between MS and CCSVI and do not support the role of CCSVI as the primary cause of MS. Until credible scientific evidence replicates the original results, any proposed invasive treatments of CCSVI should be discouraged..[Chiara:2011]
- The Canadian Institutes of Health Research and the Multiple Sclerosis (MS) Society of Canada recently convened an Invitational Panel to consider the scientific evidence linking chronic cerebrospinal venous insufficiency ( CCSVI) and MS. The panel supported studies to determine whether CCSVI causes MS, but felt that there is currently so much uncertainty about the relationship between CCSVI and MS that a clinical trial is not indicated at this time..[Andreas:2011]
- A critical analysis of the scientific methods used in the original studies of chronic cerebrospinal venous insufficiency in multiple sclerosis reveals several methodological problems with regard to potential bias and confounding. The current evidence calls into question whether chronic cerebrospinal venous insufficiency in multiple sclerosis exists at all..[Bridget:2011]{Human}
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Studies using ultrasound in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 70%; range 0-100%; N.=1496), whereas, in normal controls and patients without MS the prevalence was much lower (mean 10%; range 0-36%; N.=635). Ultrasound uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results..[Zamboni:2012]
- Chronic cerebrospinal venous insufficiency ( CCSVI) is a term used to describe impaired venous drainage from the central nervous system (CNS) caused by abnormalities in anatomy and flow affecting the extracranial veins. Recently, it has been proposed that CCSVI may contribute to the pathogenesis of multiple sclerosis (MS). It is hypothesized that venous obstruction results in abnormal flow that promotes inflammation at the blood-brain barrier and that this triggers a process marked by a disturbance of homeostasis within the CNS that leads to demyelination and neurodegeneration. The venous abnormalities of CCSVI are often diagnosed by ultrasound or magnetic resonance venography, however the prevalence of CCSVI detailed in groups of MS patients and patients without MS varies widely in published reports. Increased standardization of diagnostic studies to evaluate both anatomical and physiological findings associated with CCSVI is needed. The purpose of this article is to provide a background to understand the development of the theory of CCSVI and to frame the relevant issues regarding its diagnosis and relationship to the pathogenesis of MS..[Dake:2012]
- The pyramidal pathway is frequently affected early on in multiple sclerosis (MS) and impaired motor performance is a major cause of disability..[Plasmati:2010]{Human}
- The aetiology of multiple sclerosis remains unknown at the present time, although the most likely explanation is that it has an autoimmune inflammatory origin. During the history of this disease a vascular pathophysiology was once proposed, and it has recently re-emerged as a result of the work by Paolo Zamboni with the name of ' chronic cerebrospinal venous insufficiency'. Following this hypothesis, Zamboni puts forward a curative treatment for multiple sclerosis by means of endovascular treatment of the internal jugular vein and the azygos vein..[Carmen:2011]
- However, over the same nineteen-month period, the internet discussion on the subject of CCSVI and MS has led to countless websites advertising treatment using vascular surgery for patients with MS all over the world. The treatment based on the CCSVI theory has appealingly been called "liberation treatment", thus making it difficult to explain to patients why a treatment that has been highly praised (on the internet) cannot be recommended based on partial medical results that await confirmation..[Yára:2011]{Human}
- The presence of chronic cerebrospinal venous insufficiency ( CCSVI) was defined according to previously reported criteria for the extracranial and transcranial US techniques..[Marcello:2012]
- Chronic cerebrospinal venous insufficiency has recently been proposed to be etiologic to multiple sclerosis..[Bridget:2011]{Human}
- In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence..[Reekers:2011]
- Multiple sclerosis is highly correlated with chronic cerebrospinal venous insufficiency..[Simka:2010]{Human}
- Our findings showed a positive association between chronic cerebrospinal venous insufficiency and multiple sclerosis..[Andreas:2011]{Human}
- Clinicians should be aware that endovenous treatment of CCSVI could cause paradoxical deterioration of cerebral venous drainage..[null:2011]{Human}
- A potential shift in the treatment paradigm of MS involving endovascular balloon angioplasty or venous stent placement has been proposed as well as conducted in small patient series..[Omar:2010]{Human}
- This study is in agreement with the other series reported from Asia regarding the special clinical features of multiple sclerosis described from this part of the world. There is more common occurrence of visual impairment at onset, predominant involvement of optic nerves and spinal cord and higher incidence of classical neuromyelitis optica. There is no relationship of any or all cerebro spinal fluid abnormalities with the type of multiple sclerosis, duration of an attack and disability, except for the possible relation between the type of colloidal gold reaction pattern and the type of multiple sclerosis..[Chopra:1981]{Human}
- CDMS is strongly associated with CCSVI, a scenario that has not previously been described, characterised by abnormal venous haemodynamics determined by extracranial multiple venous strictures of unknown origin. The location of venous obstructions plays a key role in determining the clinical course of the disease..[Zamboni:2009]{Human}
- Current medication used in MS treatment as well as medications about to be approved are primarily anti-inflammatory therapies. By modulating the immune system and thereby blocking key steps of the pathology, the immunomodulation therapies in MS have a slight impact on disability progression. There is, however, clinical and experimental data concerning the potential neuroprotective properties of novel therapies. Combining anti-inflammatory and direct neuroprotective or even neuroregenerative therapy strategies would be a step forward in the treatment of multiple sclerosis..[Zipp:2011]{Human}
- Multiple sclerosis (MS) is a chronic neurological disease that typically affects young adults..[Yára:2011]{Human}
- Only one healthy control and no MS patients fulfilled at least two criteria for CCSVI. Conclusions This triple-blinded extra- and transcranial duplex sonographic assessment of cervical and cerebral veins does not provide supportive evidence for the presence of CCSVI in MS patients. The findings cast serious doubt on the concept of CCSVI in MS..[Christoph:2011]
- The myelinotoxicity of sera from multiple sclerosis (MS) patients was determined by the assessment of visible myelin damage in guinea-pig spinal cord-spinal ganglia and in rat cerebella cultivated on collagen-coated coverslips in Leighton tubes..[Hauw:1987]{Human}
- These findings may support the venous occlusion theory, but may also be explained by atrophy-dependent ventricular dilatation independent of the venous theory in MS patients..[Gorucu:2012]
- Conversely, in chronic inflammation of the central nervous system (CNS), atrophy has previously also been described and neurodegeneration is discussed as a pathologic feature. The most frequent chronic inflammatory disease of the CNS is multiple sclerosis (MS), which leads to devastating relapsing-remitting symptoms and disability during the relapses, increasingly during the course of disease in patients. Meanwhile it became clear that axons already reveal pathology early in the disease and neurons are affected in the cortex and the spinal cord, albeit to a different extent..[Zipp:2011]{Human}
- The pathophysiology of CCSVI is yet to be defined. The superior cava venous system is highly complex in terms of anatomy and possible anomalies, as well as its haemodynamic mechanisms. Further studies are required to define the parameters of diagnosis and treatment of CCSVI..[Lugli:2012]
- This study also revealed a correlation between the occurrence of inverted flow in patients in a sitting position and chronic progressive MS (P = 0.0033). The examinations undertaken indicate a possible connection between MS and CCSVI. The widely accessible and highly sensitive and specific Doppler ultrasound test may be useful for revealing, and preliminary analysis of, CCSVI pathologies..[Zaniewski:2012]
- Several scientific endeavors examining the presence of CCSVI in MS are being undertaken. At present, invasive and potentially dangerous endovascular procedures as therapy for patients with MS should be discouraged until such studies have been completed, analyzed, and debated in the scientific arena..[Omar:2010]{Human}
- Multiple sclerosis (MS) is an incurable neurological illness that frequently causes chronic disability..[Khan:1996]{Human}
- Overall, 144 children (55.8%) continued receiving 1 therapy, while 65 (25.2%), 29 (11.2%), and 20 (7.8%) received 2, 3, or 4 or more sequential therapies, respectively, during a mean (SD) observation period of 3.9 (2.8) years. Second-line DMT use was restricted to interferon beta and glatiramer acetate in 203 children (78.7%), whereas other treatments such as broad-spectrum chemotherapies (cyclophosphamide, mitoxantrone hydrochloride), natalizumab, corticosteroids (monthly), and daclizumab were used at some point during the observation period for disease management in 55 children (21.3%)..[Ann:2010]
- Three types of vascular dysfunction have been described in multiple sclerosis (MS)..[Miguel:2011]{Human}
- Ultrasound in the form of duplex scanning uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results..[Nicolaides:2012]
- Multiple Sclerosis (2000) 6 362 - 363.[Constantinescu:2000]{Human}
- Endovascular treatment of CCSVI is a safe procedure; there is a 1.6% risk of major complications..[Kenneth:2012]
- Multiple sclerosis (MS) is primarily an autoimmune disorder of unknown origin. This review focuses iron overload and oxidative stress as surrounding cause that leads to immunomodulation in chronic MS..[Ajay:2009]{Human}
- Purpose: To assess cerebral circulation times (CCTs) in patients with multiple sclerosis (MS) and control subjects by using contrast material-enhanced ultrasonography (US) to determine whether vascular abnormalities can be detected in this disease..[Marcello:2012]
- HTLV-1 in endemic in populations which are recognized as having low risk of multiple sclerosis . Multiple sclerosis generally evolves as a relapsing-remitting disease and affects predominantly Caucasians..[Jo?l:2007]{Human}
- Multiple Sclerosis (2000) 6, 66 - 68.[Hay:2000]{Human}
- CD154 (CD40-ligand, gp39), expressed on activated T cells, is crucial in T cell-dependent immune responses and may be involved in the pathogenesis of multiple sclerosis (MS)..[Jensen:2001]{Human}
- Multiple sclerosis fatigue was unrelated to either depression or global impairment. Multiple sclerosis fatigue appears to be a distinct clinical entity, often disabling, that can be distinguished from normal fatigue, affective disturbance, and neurologic impairment..[Krupp:1988]{Human}
- Increased iron deposition might be implicated in multiple sclerosis (MS)..[Michael:2011]
- The prevention of post-operative venous thromboembolic accidents is well documented..[Samama:1996]{Human}
- Clinical status was analysed as regards the age at onset, the duration and course of the disease, the disability of the patients and the treatment they received..[Davous:1978]{Human}
- Further studies are required to verify these observations and to clarify if CCT and CCSVI have any physiologic and clinical relevance in MS. © RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11111239/-/DC1..[Marcello:2012]
- Circulating immune complexes were looked for on 38 clinically definite MS ( multiple sclerosis) patients compared to 35 other neurological patients and 26 healthy subjects. 29% of the MS sera and 8.6% of the other neurological sera were positive, whereas none of the control sera were positive..[Davous:1978]{Human}
- The positive impact of education and support on adherence to therapy has been validated by training and nurse hotline data..[Madonna:2000]{Human}
- Since that time Australians have made an ever-increasing contribution to the world literature regarding MS pathogenesis, epidemiology and treatment..[Frith:1989]{Human}
- Electromyography demonstrated widespread active and chronic motor axon loss..[Dynes:2001]{Human}
|
|
|