Plasma exchange in neurology patients-experience from single center in Montenegro.

INTRODUCTION: Plasma exchange (PE) is widely used in many immune-based neurological diseases. Our aim is to analyze characteristics of PE in neurological patients at the Clinical Center of Montenegro. METHODS: Our study involved neurological patients treated with PE between January 2020 and April 2022. RESULTS: In total, 246 PEs were performed in 43 patients. We divided patients into 4 groups according to indications. In 8/9 multiple sclerosis (MS) patients a decrease of Expanded Dysability Status Scale at least 0.5 was verified. In 14/20 Guillain Barre syndrome patients reduction of Hughes was observed. Four patients with myasthenia gravis (MG) were treated with PE. The most heterogeneous group (4) consisted of patients in whom the mechanism of disease development is assumed to be immune system dysregulation. Fourteen patients had any adverse event. CONCLUSION: Our results show that PE is widely used and safe in the treatment of neurological diseases.

Screening of dysphagia in relapsing-remitting multiple sclerosis patients in Montenegro.

OBJECTIVES: To perform screening of dysphagia in Montenegrin multiple sclerosis (MS) patients. Dysphagia is often neglected problem in patients with MS. METHODS: We included 104 patients with relapsing-remitting MS who completed 3 questionnaires: dysphagia in multiple sclerosis (DYMUS), eating assessment tool-10 (EAT-10) and swallowing disturbance questionnaire (SDQ). Our study was performed in the clinic for neurology of the Clinical Center of Montenegro (Podgorica, Montenegro) and Polyclinic Neuron (Bijelo Polje, Montenegro) between November 2020 and December 2020. RESULTS: Self-reported prevalence of this symptom in our group was simmilar to previously reported results. We did not find correlation between DYMUS and expanded disability status scale (EDSS), as it was reported before. Time spent from disease onset to diagnosis is strongly correlated with reported SDQ results. The population of dysphagia-patients is statistically significantly older compared to the non-dysphagia patients, and statistically higher mean values in this population of our subjects were proven on all 3 questionnaires used. CONCLUSION: The importance of this issue is not just because it warns of potientially malnutrion in MS patients, but also important factor in therapy choosing algorithm in the era of orally used immunomodulatory drugs.

Reorganization of multiple sclerosis health care system in Clinical Centre of Montenegro during the COVID-19 pandemic.

The COVID-19 epidemic has brought a number of changes to health systems, including the provision of health services to patients with multiple sclerosis (MS). Work in the Clinic for Neurology of the Clinical Center of Montenegro (CN-CCM) with MS patients continued as much as possible during the epidemic. The administration of the already started disease-modifying therapy (DMT) continued, and the introduction of the new one was postponed until the moment when the epidemic started to slow down. During the epidemic period, plasmapheresis treatment was performed in CN-CCM without any complications. New ways of communications (special e-mail address and phone line) with MS patients during epidemic were realized. During epidemic, smaller number of relapses were reported compared to same period in 2019. There were not MS patients in Montenegro suffering from SARS-Cov2 virus infection.