RESUMEN
The aim of the study was to describe the atrophy of the thalamus in young patients with active relapsing multiple sclerosis (MS) treated with cerebrolysin. Eighteen MS patients (mean age 20.10±0.45 years) with disease onset in childhood or adolescence were studied. Neurological examination using the EDSS, neuropsychological testing and MRI were used. At baseline, MRI revealed the hypotrophy of the thalamus that was not correlated with the performance on neuropsychological tests. After treatment with cerebrolysin, there was the decrease in the level of atrophy that suggested the neuroprotective effect of this drug. This effect was more prominent in younger patients with the high frequency of previous relapses.
Asunto(s)
Aminoácidos/uso terapéutico , Imagen por Resonancia Magnética/métodos , Esclerosis Múltiple Recurrente-Remitente/diagnóstico , Degeneración Nerviosa , Fármacos Neuroprotectores/uso terapéutico , Tálamo/patología , Adolescente , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Tamaño de los Órganos , Reproducibilidad de los Resultados , Adulto JovenAsunto(s)
Infecciones Bacterianas del Sistema Nervioso Central/diagnóstico , Infecciones por VIH/diagnóstico , Esclerosis Múltiple/diagnóstico , Adulto , Encéfalo/diagnóstico por imagen , Infecciones Bacterianas del Sistema Nervioso Central/diagnóstico por imagen , Infecciones Bacterianas del Sistema Nervioso Central/tratamiento farmacológico , Infecciones Bacterianas del Sistema Nervioso Central/virología , Diagnóstico Diferencial , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico por imagen , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Esclerosis Múltiple/diagnóstico por imagen , Esclerosis Múltiple/tratamiento farmacológico , Radiografía , Médula Espinal/diagnóstico por imagenRESUMEN
Experience of 10-year administration of glatimer acetate (copaxone) in 74 patients with active remitting multiple sclerosis is summarized. The significant decrease in the frequency of exacerbations was seen over these ten years. Disease severity on the EDSS was stable and decreased only to the end of the 10-year period. The positive stable clinical dynamics did not depend on the disease severity at baseline. The drug was well-tolerated that allowed to control the course of multiple sclerosis: 64.8% of patients had no more than one exacerbation over 10 years and in 71.6% patients, the disease progression was absent or minimal (less than one score on EDSS). It has been concluded, that the long-term 10-year treatment with copaxone enables to control the development of disease in many patients.
Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Inmunosupresores/uso terapéutico , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Péptidos/uso terapéutico , Adyuvantes Inmunológicos/efectos adversos , Adulto , Femenino , Acetato de Glatiramer , Humanos , Inmunosupresores/efectos adversos , Masculino , Moscú , Péptidos/efectos adversos , Resultado del TratamientoRESUMEN
The experience of the treatment of patients with remitting multiple sclerosis (MS) with intramuscular introduction of beta-interferon-1a (avonex) is presented. Seventeen children and adolescents, aged from 11 to 18 years, and 55 adults, aged over 55 years, were treated for at least one-year period. Results revealed a significant reduction of exacerbations in both groups (from 1.35 to 0.06 in average in adolescents and from 0.86 to 0.17 in adults). The changes were accompanied by the stabilization of MS severity index: EDSS scores have decreased in 23.6% of adults and in 17.6% of adolescents. In both groups, good tolerability of the treatment was noted. There was a low probability of side-effects with the exception of increased frequency of a flu-like syndrome (47% cases) in patients younger than 18 years that demands special attention from children neurologists. The high efficacy and good tolerability and safety profile of beta-interferon-1a give grounds for administering this drug to children and adolescents with MS.
Asunto(s)
Adyuvantes Inmunológicos/administración & dosificación , Interferón beta/administración & dosificación , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Adyuvantes Inmunológicos/efectos adversos , Adolescente , Niño , Esquema de Medicación , Femenino , Humanos , Inyecciones Intramusculares , Interferón beta-1a , Interferón beta/efectos adversos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Current data on the etiology, pathogenesis, diagnosis and treatment principles of HIV are reviewed. The special attention is focused on affections of the nervous system (neuro-AIDS). Primary and secondary manifestations of these affections are described.
Asunto(s)
Enfermedades del Sistema Nervioso Central/diagnóstico , Enfermedades del Sistema Nervioso Central/virología , Infecciones por VIH/complicaciones , Complejo SIDA Demencia/diagnóstico , Complejo SIDA Demencia/tratamiento farmacológico , Enfermedades del Sistema Nervioso Central/tratamiento farmacológico , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Humanos , Enfermedades de la Médula Espinal/diagnóstico , Enfermedades de la Médula Espinal/tratamiento farmacológico , Enfermedades de la Médula Espinal/virologíaRESUMEN
Motor and coordination disorders are the most prominent clinical presentations of multiple sclerosis. Currently, good results were achieved in the pathogenetic treatment of the disease. However methods of treatment of motor and coordination disorders are not widely used. The positive experience in the treatment of motor disorders using the apparatus Moto-med is presented. The use of this treatment led to positive changes in the state of motor functions, i.e. the decrease of neurologic deficit and improvement of quality of life, of patients.
Asunto(s)
Ataxia/rehabilitación , Técnicas de Ejercicio con Movimientos/instrumentación , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/fisiopatología , Adulto , Ataxia/economía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Symptomatic therapy of bladder hyporeflexia in patients with multiple sclerosis by intermittent catheterization in cases of insufficient efficacy of alpha-adrenoblockers allows to prevent bacterial infection complications and chronic renal failure and to achieve significant improvement of quality of life of such patients.
Asunto(s)
Antagonistas Adrenérgicos alfa/uso terapéutico , Esclerosis Múltiple/complicaciones , Reflejo Anormal/fisiología , Vejiga Urinaria Neurogénica/tratamiento farmacológico , Humanos , Resultado del Tratamiento , Vejiga Urinaria Neurogénica/etiología , Vejiga Urinaria Neurogénica/fisiopatología , Urodinámica/efectos de los fármacosRESUMEN
In last decades, practical neurologists are able to use DMT in multiple sclerosis (MS) in every day practice. This paper presents data of 3-year study of DMT (copaxone and betaferon) treatment of 280 patients with definite diagnosis of multiple sclerosis (MS), 166 patients regularly receiving DMT (104--copaxone and 62--betaferon) for, at least, 3 years. Clinical symptoms of the patients, reasons of treatment withdrawal (48--copaxone and 31--betaferon) and the features of MS course after the withdrawal are analyzed. Patients who received betaferon previously had more severe MS course with frequent relapses, half of them had secondary progressive MS course (SPMS) with relapses. This made impossible a direct comparison of the data of two treatment groups. Treatment with copaxone reduced 5 times annual relapse rate, from 1.45 before DMT to 0.27 during these 3 years (p < 0.001), and this reduction remained stable. For 36 months, 40.4% of patients were relapse-free though all of them had, at least, one relapse per year before the treatment. No EDSS progression was observed in 80% of these patients. Treatment with betaferon caused the reduction of relapse rate from 1,84 to 0,69 per year (2.7 times), 8 patients (26%) with previously active RMS being relapse-free for 36 months. In 31 patients with SPMS, the reduction of relapse rate was also significant, from 1.89 to 0.49 (3.8 times, p < 0.001). Twenty-two patients (71%) with previous SPMS did not have EDSS progression for 36 months that indicate the positive effect of the therapy. Side-effects were moderate and were not the main cause of the treatment withdrawal. The latter was caused mainly by clinical un efficacy, most frequently by the increase of EDSS due to transformation of the MS course to SPMS without relapses and poor understanding by the patient of the goals and the possibilities of DMT. These facts stress the significance of improving compliance, motivation and adherence to DMT in everyday neurological practice.