Correlation of clinical findings and brain volume data in multiple sclerosis.

Brain volume measurements are becoming an important tool for assessing success in controlling multiple sclerosis (MS) activity. MSmetrix (icometrix) is an easy-to-use platform, specific for MS magnetic resonance imaging (MRI) of the brain. It provides data on total brain volume, grey matter volume and lesion load volume. The objective of the present study was to assess whether disability and the number of relapses during the previous year correlated with brain volume measurements from MSmetrix. Data on 185 icometrix reports from patients with MS were used to evaluate the potential correlation between brain volume measurements and clinical parameters. There was a significant correlation between higher disability and decreased brain volume (total and grey matter). Increased lesion load in the brain and higher number of relapses in the previous year were also independently correlated with decreased brain tissue volume and with increased disability. This is the first study with real-world data to show that icometrix is a relevant tool for the study of brain volume loss in MS.

Alternatives for reducing relapse rate when switching from natalizumab to fingolimod in multiple sclerosis.

Natalizumab is a therapeutic option for treating multiple sclerosis (MS) and is particularly efficacious for patients with highly active disease. A long washout period has been recommended between withdrawal of natalizumab and start of fingolimod (another option for treating MS). This long washout period has been associated with a significant increase in MS activity. In the present study, a group of 96 patients who were switched from natalizumab to fingolimod had short washout periods between drugs, or monthly corticosteroid pulse therapy if longer washout periods were recommended. This therapeutic approach led to the lowest reported relapse rate so far, among patients with MS switching from natalizumab to fingolimod (8.3%). No complications from short withdrawal were observed in this group of patients.

Neurocisticercose no estado do Espírito Santo: avaliaçäo de 45 casos / Neurocysticercosis in the State of Espírito Santo, Brazil: evaluation of 45 cases

Foram analisados 45 casos de neurocisticercose (NC) no Serviço de Neurologia do Hospital Universitário Cassiano Antonio Moraes da UFES, observados de janeiro-1987 a janeiro-1989, submetidos a protocolo de investigaçäo clínica, laboratorial (LCR) e radiológica (TC e, quando necessário, RM). O protocolo foi aplicado em todo paciente que apresentou suspeita clínica de NC: epilepsia parcial, meningite asséptica e síndrome de hipertensäo intracraniana (SHIC). O dignóstico de NC foi estabelecido por no mínimo dois dos critérios do protocolo proposto. Foram obtidos dados referentes a sexo, idade, forma clínica, quadro do LCR, e radiológico (TC e RM), tratamento e evoluçäo clínica. Näo houve variaçäo quanto ao sexo e as didades variaram dos 3 aos 67 anos. O tempo de seguimento foi de dois anos, que demonstrou o caráter recidivante da NC. As formas clínicas mais comuns foram a hipertensiva (51%), a epiléptica (48%) e a meningítica (8,8%). O RX de crânio mostrou presença de calcificaçöes (28%), erosäo da sela túrcica (8%); na TC evidenciamos calcificaçöes (47.3%), cistos (56%), granulomas (24,9%), hidrocefalia (34,2%); em um caso a mielografia mostrou bloqueio a nível de T8-T9. O exame do LCR mostrou: pleocitose linfomononuclear (66%), eosinófilos (34%), plasmócitos e/ou macrófagos (38%), hiperproteinorraquia (42%); as reaçöes de fixaçäo de complemento (65,2%), imunofluorescência (43,7%) e ELISA (31,2%) foram positivas em pelo menos uma vez em cada caso. Tratamento específico foi realizado ...