Description
This concise, abundantly illustrated text provides a complete overview of multiple sclerosis for the internist, general neurologist and therapist. Including recent research findings in genetics, immunology and pathophysiology, the authors provide reliable and up-to-date guidance on the epidemiology, diagnosis, prognosis and treatment of MS. Of particular interest to neuroscientists and neurologists will be the reviews of experimental models of MS, pathology of the demyelinated plaque, HLA associations and the role of immune mechanisms. Environmental and geographical factors in the etiology of MS are examined, including the possible role of infectious agents. The clinical sections of the book include discussion of neurological, sexual, psychological and cognitive disturbances. Diagnostic criteria are reviewed, and rehabilitation measures are given special attention.
Chapter
Plaques with destruction of astrocytes
PATHOLOGY OF THE NERVOUS SYSTEM OUTSIDE THE PLAQUES
DISTRIBUTION OF PLAQUES IN THE NERVOUS SYSTEM
Experimental autoimmune encephalomyelitis
Target antigens for autoimmunity in EAE
Models of virus-induced demyelination
Theiler's virus encqjhalomyelitis
Canine distemper encephalomyelitis
Models of inflammatory demyelination in the peripheral nervous system
Experimental autoimmune neuritis
The value of experimental models for MS research
Chapter 3 Genetics and immunology
Relation between the HLA system and MS
IMMUNOLOGY OF THE CENTRAL NERVOUS SYSTEM
Interaction of T-lymphocytes with cells of the central nervous system
The role of immune mechanisms in MS patients
Alterations of immunological parameters in the peripheral blood and cerebrospinal fluid of MS patients
Immunological aspects of animal models
GEOGRAPHICAL DISTRIBUTION OF PREVALENCE
GEOGRAPHICALLY WELL-DEFINED REGIONS
DISTRIBUTION ACCORDING TO ACE, SEX, FAMILY, AND RACE
Factors triggering exacerbation
SPECIAL PATHOCENESIS OF PLAQUES
Pathogenesis of the inflammatory reaction
Pathogenesis of demyelination and tissue destruction
Chapter 6 Pathophysiology of impaired neural transmission
ELECTROPHYSIOLOGY OF NORMAL NERVE FIBERS
PATHOPHYSIOLOCY OF DEMYELINATED NERVE FIBERS
Electrophysiological properties
Influence of temperature and calcium
Possible consequences of increased excitability
OTHER MECHANISMS OF IMPAIRED CONDUCTION
OPHTHALMOLOGICAL DISTURBANCES
Disturbances of ocular movements
DISTURBANCES OF BLADDER FUNCTION
PSYCHOLOGICAL DISTURBANCES
PAROXYSMAL PHENOMENA AND INVOLUNTARY MOVEMENTS
Paroxysmal phenomena of extracorticalorigin
Clinical evidence of lesions
Paraclinical evidence of a lesion
NEUROPHYSIOLOGICAL INVESTIGATIONS
The principle of afferent evoked brain potentials
Somatosensory evoked potentials
Brainstem auditory evoked potentials
Motor evoked potentials induced by transcranial stimulation of the cortex
Assessment of oculomotor disturbances by oculography
Combined cystomanometric- electromyographic investigation of bladder and sphincter function
MAGNETIC RESONANCE IMAGING
Magnetic resonance imaging in optic neuropathies and clinically isolated brainstem and spinal cord syndromes
Cerebrospinal fluid profile in multiple sclerosis (Tourtellotte and Walsh 1984)
RELAPSING REMITTING COURSE
Factors triggering or related to relapses
PRIMARY AND SECONDARY PROGRESSIVE COURSES
FREQUENCY OF VARIOUS COURSES
Chapter 11 Differential diagnosis
Systemic lupus erythematosus
Primary Sjogren's syndrome
Granulomatous angiitis of the nervous system
INFLAMMATORY AND GRANULOMATOUSDISEASES
Acute disseminated encephalomyelitis
Acquired immunodeficiency syndrome
GENETIC AND METABOLIC DISEASES OF THE CENTRAL NERVOUS SYSTEM
Spinocerebellar degeneration
Subacute combined degeneration
Chapter 12 Assessment of performance, ability, and disability
Part III Management and therapy
Chapter 13 Symptomatic treatment and nutrition
ASSESSING DISEASE EVOLUTION AND THERAPEUTIC EFFECTS
TREATMENTS DIRECTED AT THE MS DISEASE PROCESS
Treatments aimed at reducing relapse rate and halting progression
Nonselective immunosuppressants
Total lymphoid irradiation
Chemically defined substances
Monoclonal antibodies against T-cell sub-populations and activation markers
IMPROVEMENT OF CONDUCTION, ENHANCING REMYELINATION
Appendix: Assessment Scales
NEUROLOGICAL ASSESSMENT KURTZKE FUNCTIONAL SYSTEMS (FS)
NEUROLOGICAL ASSESSMENT KURTZKE EXPANDED DISABILITY STATUS SCALE (EDSS)
INCAPACITY STATUS SCALE (ISS)
ENVIRONMENTAL STATUS SCALE (ESS)
MINIMAL RECORD OF DISABILITY SUMMARY RECORD OF CLINICAL SCORES AND NOTES
Multiple Sclerosis
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