RESUMO
We carried out a randomized, double-blind, placebo-controlled trial of hyperbaric oxygen therapy (HBO) in patients with chronic stable MS. Eighty-two patients were treated in a multiplace hyperbaric chamber with gas supplied by mask. Forty-one patients received 20 consecutive daily treatments of 100% O2 followed by 7 "booster" treatments in the next 6 months; 41 control patients received "air" (12.5% O2 at 1.75 atmospheres absolute). There was no significant difference in treatment and control groups in the Extended Kurtzke Disability scores, Kurtzke Functional scores, magnetic resonance imaging, or evoked potentials after the initial 20 treatments or after the boosters. HBO is not effective in treating chronic stable MS.
Assuntos
Oxigenoterapia Hiperbárica , Esclerose Múltipla/terapia , Adulto , Idoso , Doença Crônica , Ensaios Clínicos como Assunto , Método Duplo-Cego , Potenciais Evocados Auditivos , Potenciais Evocados Visuais , Humanos , Oxigenoterapia Hiperbárica/efeitos adversos , Espectroscopia de Ressonância Magnética , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico , Distribuição AleatóriaRESUMO
We have examined the diagnostic significance of finding one band in the immunoglobulin (IgG) region in spinal fluid protein electrophoresis. From January 1983 to January 1986, 855 consecutive CSF electrophoreses were performed on as many patients. A blinded observer identified a single band in the IgG region in 53 cases (6.2%). In only 14 patients (26%), were the clinical features ultimately felt to be due to clinically definite or possible multiple sclerosis (MS). The majority of patients with a single band had another neurological diagnosis (55%) or were neurologically normal (6%). Many of the neurological disorders in which a single band was found were not disorders in which an increased intrathecal synthesis of immunoglobulin or electrophoretic restriction would have been expected. A variety of conditions can produce a single band pattern. The significance of these patterns and the means by which they might be identified are described.
Assuntos
Encefalopatias/imunologia , Cadeias Pesadas de Imunoglobulinas , Cadeias gama de Imunoglobulina , Esclerose Múltipla/imunologia , Encefalopatias/líquido cefalorraquidiano , Encefalopatias/diagnóstico , Eletroforese em Gel de Ágar , Humanos , Cadeias gama de Imunoglobulina/líquido cefalorraquidiano , Esclerose Múltipla/líquido cefalorraquidiano , Esclerose Múltipla/diagnósticoRESUMO
A central nervous system illness closely resembling multiple sclerosis has been described in patients with primary Sjögren's syndrome. From these reports, the estimated prevalence of this syndrome could be similar to that of multiple sclerosis in a high-frequency area. We evaluated 192 consecutive patients in our multiple sclerosis clinic to determine if such cases had gone unrecognized. We did not find any patients with clinical or serological evidence of primary Sjögren's syndrome. We conclude that it is rare for neurological manifestations of Sjögren's syndrome to mimic multiple sclerosis in our population.