Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
Treatment changes in a cohort of people with apparently drug-resistant epilepsy: an extended follow-up.
The seizure response to the addition of a previously unused antiepileptic drug in a cohort of 155 people with refractory epilepsy was previously reported after a median of 18 months follow-up. ⋯ This suggests that about half of people with apparent drug-resistant epilepsy can have significant improvements in seizure control with further drug changes. Some will subsequently relapse, but long periods of seizure freedom or significantly improved seizure control in the absence of complete seizure control can occur. Such valuable improvements suggest that the recently proposed International League against Epilepsy definition of refractory epilepsy may be too restrictive.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
Reduced R2' in multiple sclerosis normal appearing white matter and lesions may reflect decreased myelin and iron content.
R(2)' is an MRI measure of microscopic magnetic field inhomogeneity, and is increased by the paramagnetic effect of iron and the diamagnetic effect of myelin. R(2)' may detect features of multiple sclerosis (MS) not evident with conventional MRI. ⋯ Reduction in R(2)' in NAWM and lesions is consistent with a decreases in myelin, tissue iron and/or deoxyhaemoglobin. Increased caudate R(2)' in patients with secondary progressive MS is consistent with increased iron deposition, as corroborated by other techniques.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
Term pregnancies and the clinical characteristics of multiple sclerosis: a population based study.
Pregnancy has a well documented effect on relapse risk in multiple sclerosis (MS). Prospective studies have reported a significant decline by two-thirds in the rate of relapses during the third trimester of pregnancy and a significant increase by two-thirds during the first 3 months postpartum. However, it is unclear as to whether there are any long term effects on disability. ⋯ Pregnancy had no effect on the time to reach an EDSS score 6. As MS predominantly affects women of childbearing age, women with MS can be reassured that term pregnancies do not appear to have any long term effects on disability.