[Chronic meningitis: etiologies and diagnostic work-up]. / Méningite chronique : étiologies et approche diagnostique.

We describe the case of a 62-year-old woman who presented with insidious onset and slowly progressive neurological complaints. This case illustrates the diagnostic challenges clinicians face because the lack of specific symptomatology and numerous complementary exams. The broad differential diagnosis of this disease requires a diagnostic strategy to be developed. Clinical reasoning is based on clinical, biological and radiological information and highlights the importance of an interdisciplinary approach to patient care.

Nous décrivons le cas clinique d'une patiente de 62 ans se présentant avec des symptômes neurologiques d'apparition progressive et lentement évolutifs. Ce cas illustre un défi diagnostique étant donné l'absence de spécificité des symptômes et des divers examens complémentaires à disposition. Le large diagnostic différentiel de cette affection requiert une stratégie diagnostique élaborée. Le raisonnement clinique se fonde sur des informations cliniques, biologiques et radiologiques et nécessite une approche multidisciplinaire pour finalement accéder au diagnostic.

Role of Family Planning in Women With Multiple Sclerosis in Switzerland: Results of the Women With Multiple Sclerosis Patient Survey.

Background: Women of child bearing age with multiple sclerosis (MS) must carefully consider treatments when planning a family, since disease modifying drugs (DMDs) are contraindicated during pregnancy. Objectives: This questionnaire-based study aimed to improve understanding of the effect of family planning on treatment decisions in female, Swiss MS patients. Methods: Female patients with MS (aged 18-55 years) participated in the 26-question survey between September 2014 and August 2015. Information captured included patient background, family planning status, treatment course, and previous pregnancies. Results: In total, 271 questionnaires distributed from 15 MS centres were returned for analysis. Of these, 250 (92.3%) participants received DMD therapy and 106 (39.1%) wanted children or were pregnant. Significantly more patients with a short-term plan to conceive within 2 years were treated with injectables (19/54) compared with those without a plan to conceive (19/108; p = 0.013). A proportionally greater number of women not planning to conceive took oral (34/108) or infusion therapies (41/108) compared with those with a short- (13/54 and 16/54, respectively) or medium-term (after 2 years or more; infusion therapy only, 14/44) plan to conceive. Conclusion: The study highlights that pregnancy remains an important yet unresolved concern in the treatment of MS patients. Nearly all women received DMD treatment, and type of DMD treatment was influenced by family planning, with significantly more women with a short-term plan to conceive using injectables.