A number of studies have demonstrated that deep-brain stimulation (DBS) can improve mobility, ADLs and QOL measures in patients with advanced PD with severe motor complications (Deep-Brain Stimulation for Parkinson’s Disease Study Group. N Engl J Med 2001;345:956-963. Deuschl et al. N Engl J Med 2006;355:896-908; free full text at www.nejm.org/doi/pdf/10.1056/NEJMoa060281). Read More
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Clinical Issues in Multiple Sclerosis
December 12, 2013Issues in Multiple Sclerosis
Early diagnosis, identification of non-responders and brain atrophy in MS
Professor Xavier Montalban, MD, PhD
Professor of Neurology
Universitat Autònoma de Barcelona (UAB)
Director, Multiple Sclerosis Centre of Catalonia
Head, Neuroimmunology Group
Vall d’Hebron Institute of Research
Barcelona, Spain Read More
MS treatment: What is Plan B?
December 5, 2013
Comment by Dr. Paul Steven Giacomini
NeuroSens survey on sequencing
The year 2013 was the twentieth anniversary of the first published trial of a disease-modifying therapy (DMT) in multiple sclerosis, an occasion marked by the arrival of two new oral agents in an expanding armamentarium of MS therapies. Teriflunomide got the green light in Canada and Europe (previously approved in the U.S.); and dimethyl fumarate (DMF) was approved in Canada and the U.S. (but is still pending in Europe).
Laquinimod, fast-tracked by the FDA four years ago, appears to be idling at the curb. Read More
No additive relapse risk with second pregnancy
December 2, 2013REPORT FROM THE EUROPEAN CHARCOT FOUNDATION ANNUAL MEETING – BAVENO, ITALY, NOVEMBER 28-30, 2013 – It is well established that relapse frequency declines during pregnancy, followed by an increased relapse risk during the first three months postpartum (Vukusic et al. Brain 2004;127(Pt 6):1353-1360). A similar pattern appears to occur during a second pregnancy, so relapse risk is not additive, according to Dr. Sandra Vukusic, Lyons, France (Vukusic S. ECF 2013).
When faced with a patient who wants to become pregnant again, clinicians can offer the same advice as they gave for the first pregnancy. It should be noted that patients receiving in vitro fertilization have a higher risk of relapse following the procedure because of exposure to gonadotrophin releasing hormone (GnRH) agonists; the relapse risk is higher in women who do not become pregnant with IVF (Michel et al. J Neurol Neurosurg Psychiatry 2012;83:796-802).