MS, Multiple sclerosis

MS,多发性硬化
  • 文章类型: Journal Article
    未经证实:由于症状重叠,合并多发性硬化(MS)和退行性脊髓型颈椎病(DCM)患者的手术治疗有明显延迟.这篇综述的目的是评估手术干预是否对同时出现的患者有益。
    UNASSIGNED:手术对并发MS和DCM有益吗?
    UNASSIGNED:在Pubmed和Medline数据库上进行了无日期限制的文献检索。关键词检索:退行性脊髓型颈椎病,多发性硬化症,治疗,手术,生活质量。随机对照试验,prospective,回顾性,和病例系列报告手术时机,术后结果,如脊髓病变症状的改善,生活质量,所有严重并发症均包括在内.
    UNASSIGNED:文献检索在所有数据库中总共产生了8项研究。选择了七篇文章进行全文审查,所有这些都被分段纳入本次审查。七项研究评估了160名并发多发性硬化症和退行性颈椎病的参与者。早期的研究不鼓励对这部分患者进行手术,大多数研究发现,对伴有多发性硬化症和退行性脊髓压迫的患者进行早期手术是值得的,如果患者有神经根病。MS患者的生活质量没有MS患者的改善。
    未经证实:患有神经根病的患者,颈部疼痛和脊髓压迫最有可能受益于早期手术。除非存在其他医疗/麻醉禁忌症,否则无需延迟提供手术。
    UNASSIGNED: Due to an overlap in symptoms, there is significant delay in surgical treatment of patients that have concomitant multiple sclerosis (MS) and degenerative cervical Myelopathy (DCM). The purpose of this review is to evaluate if surgical intervention is beneficial to patients that have concurrent presentations.
    UNASSIGNED: Is surgery beneficial in concurrent MS and DCM?
    UNASSIGNED: A literature search with no date restrictions was conducted on Pubmed and Medline databases. Keywords searched: Degenerative Cervical Myelopathy, Multiple sclerosis, Treatment, Surgery, Quality of Life. Randomised controlled trials, prospective, retrospective, and case series reporting timing of surgery, post-operative outcomes such as improvement in myelopathic symptoms, quality of life, and any serious complications were included.
    UNASSIGNED: The literature search yielded a total of 8 studies across all databases. Seven articles were selected for full text review, and all of them were sectioned for inclusion in this review. Seven studies evaluated 160 participants with concurrent multiple sclerosis and degenerative cervical myelopathy. Earlier studies had discouraged performing surgery in this subset of patients, the majority of studies found it worthwhile to perform early surgery for patients with concomitant multiple sclerosis and degenerative cord compression, if the patients had radiculopathy. Quality of life for MS patients did not improve as much as it did for patients that did not have MS.
    UNASSIGNED: Patients with radiculopathy, neck pain and cord compression are most likely to benefit from early surgery. There is no need for delaying to offer surgery unless other medical/anaesthetic contraindications exist.
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  • 文章类型: Case Reports
    白塞病(BD)是一个多系统,自身免疫性血管炎疾病影响小,中等,大血管,对发病机制知之甚少。通常表现为复发性阿弗他溃疡,生殖器溃疡,皮肤损伤,和双侧葡萄膜炎。少于10%的病例出现神经系统症状并发展,平均而言,首次出现非神经系统症状后5-6年。这个介绍,被称为神经白塞病(NBD),与BD的预后较差有关。NBD的治疗取决于症状的严重程度和其他全身性表现的存在,但通常最初涉及糖皮质激素和疾病调节剂。此病例报告介绍了一名44岁的女性患者,以前诊断为BD,出现神经系统症状和MRI表现与NBD一致。
    Behcet\'s disease (BD) is a multisystem, autoimmune vasculitis disorder affecting small, medium, and large blood vessels, with poorly understood pathogenesis. It commonly presents with recurrent aphthous ulcers, genital ulcers, skin lesions, and bilateral uveitis. Neurological symptoms are present in less than 10% of cases and develop, on average, 5-6 years after the first non-neurological symptoms. This presentation, known as Neuro-Behcet\'s disease (NBD), is associated with a worse prognosis of BD. Treatment for NBD is dependent on the severity of symptoms and the presence of other systemic manifestations but often initially involves glucocorticoids and a disease-modifying agent. This case report presents a 44-year-old female patient, previously diagnosed with BD, who presented with neurological symptoms and MRI findings consistent with NBD.
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  • 文章类型: Journal Article
    背景:鉴于新出现的冠状病毒大流行,关于SARS-CoV-2对多发性硬化症(MS)患者的影响的知识需求持续增长。与普通人群相比,接受MS疾病修饰治疗(DMT)的患者具有更高的感染相关医疗保健利用背景风险。因此,有必要提供循证建议,以降低感染风险,同时管理SARS-CoV-2MS患者.
    方法:我们介绍了3例有多发性硬化(MS)病史的DMT患者,其MS症状恶化,可能是假性加重,被诊断为COVID-19。
    结论:对7篇文章进行了广泛的回顾,除了简要回顾DMT在患有COVID-19的MS患者中的使用。在我们的案例中,所有患者均接受DMT治疗,2例患者病程严重。没有观察到死亡。
    结论:这篇综述提供了基于临床特征的基础,结果和DMT在患有n-cov-2的MS患者中的作用。医师需要警惕MS患者考虑COVID-19感染相关复发,特别是在这个COVID-19大流行的时代,寻找伪恶化。由于发现大多数病例在DMT上病程温和且完全恢复,需要进一步的研究来制定循证指南.这篇综述将特别有助于研究人员和注册管理机构收集未来关于MS和COVID-19的数据。
    BACKGROUND: In view of the emerging coronavirus pandemic, the demand for knowledge about the impact of SARS-CoV-2 on people with Multiple Sclerosis (MS) continues to grow. Patients receiving disease modifying therapy (DMT) for MS have a higher background risk of infection-related health care utilization when compared to the general population. Therefore, there is a need of evidence-based recommendations to reduce the risk of infection and also managing MS patients with SARS-CoV-2.
    METHODS: We present three patients with history of Multiple Sclerosis (MS) on DMTs presenting with worsening MS symptoms likely pseudo exacerbation who were diagnosed with COVID-19.
    CONCLUSIONS: An extensive review of 7 articles was performed, in addition to a brief review on DMTs use in MS patients with COVID-19. In our cases, all patients were on DMT and severe course of disease was noted in 2 cases. No fatality was observed.
    CONCLUSIONS: This review provides a base on the clinical characteristics, outcomes and the roles of DMTs in MS patients suffering from n-cov-2. Physicians need to be vigilant about considering COVID-19 infection related relapse in the MS patients, especially in this COVID-19 pandemic era and look for pseudo-exacerbation. As most cases are found to have mild course and full recovery on DMTs, further research is needed to formulate evidence-based guidelines. This review will particularly be helpful for the researchers and registries to collect future data on MS and COVID-19.
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