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  • 1
    Electronic Resource
    Electronic Resource
    Functional correlates of callosal atrophy in relapsing-remitting multiple sclerosis patients. A preliminary MRI study (1998)
    Springer
    Journal of neurology 245 (1998), S. 153-158 
    Details
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Periventricular lesions ; Callosal ; atrophy ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In multiple sclerosis (MS), periventricular lesions produce atrophy of the corpus callosum (CC), as evidenced by magnetic resonance imaging (MRI). We investigated whether CC atrophy in relapsing-remitting MS patients is related to functional deficits. We compared 14 mildly disabled (mean Expanded Disability Status Scale score 2.7) relapsing-remitting MS patients with 14 age- und sex-matched controls. CC size was determined using sagittal T1-weighted MRI. The function of the CC was studied using a neuropsychological battery and neurophysiological evaluation based on visual stimulation using a divided visual field paradigm. The total area of the CC in patients (mean 5.3cm2) was significantly (P=0.002) smaller than in controls (mean 6.6cm2). Patients showed left ear extinction using the dichotic listening test and impaired name learning, which was correlated with atrophy of the splenium. There were no differences in interhemispheric transfer time between patients and controls. Marked atrophy of the CC can be encountered in relapsing-remitting MS patients. The associated cerebral disconnection correlated with atrophy of expected regions of the CC, thus supporting topographical organization.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050196
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  • 2
    Electronic Resource
    Electronic Resource
    Comparison of a conventional cardiac-triggered dual spin-echo and a fast STIR sequence in detection of spinal cord lesions in multiple sclerosis (2000)
    Springer
    European radiology 10 (2000), S. 753-758 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Multiple sclerosis ; MR imaging ; Spinal cord
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The current optimal imaging protocol in spinal cord MR imaging in patients with multiple sclerosis includes a long TR conventional spin-echo (CSE) sequence, requiring long acquisition times. Using short tau inversion recovery fast spin-echo (fast STIR) sequences both acquisition time can be shortened and sensitivity in the detection of multiple sclerosis (MS) abnormalities can be increased. This study compares both sequences for the potential to detect both focal and diffuse spinal abnormalities. Spinal cords of 5 volunteers and 20 MS patients were studied at 1.0 T. Magnetic resonance imaging included cardiac-gated sagittal dual-echo CSE and a cardiac-gated fast STIR sequence. Images were scored regarding number, size, and location of focal lesions, diffuse abnormalities and presence/hindrance of artifacts by two experienced radiologists. Examinations were scored as being definitely normal, indeterminate, or definitely abnormal. Interobserver agreement regarding focal lesions was higher for CSE (ϰ = 0.67) than for fast STIR (ϰ = 0.57) but did not differ significantly. Of all focal lesions scored in consensus, 47 % were scored on both sequences, 31 % were only detected by fast STIR, and 22 % only by dual-echo CSE (n. s.). Interobserver agreement for diffuse abnormalities was lower with fast STIR (ϰ = 0.48) than dual-echo CSE (ϰ = 0.65; n. s.). After consensus, fast STIR showed in 10 patients diffuse abnormalities and dual-echo CSE in 3. After consensus, in 19 of 20 patients dual-echo CSE scans were considered as definitely abnormal compared with 17 for fast STIR. The fast STIR sequence is a useful adjunct to dual-echo CSE in detecting focal abnormalities and is helpful in detecting diffuse MS abnormalities in the spinal cord. Due to the frequent occurrence of artifacts and the lower observer concordance, fast STIR cannot be used alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050998
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  • 3
    Electronic Resource
    Electronic Resource
    Spinal cord magnetic resonance imaging in suspected multiple sclerosis (2000)
    Springer
    European radiology 10 (2000), S. 368-376 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Multiple sclerosis – Magnetic resonance imaging – Spinal imaging – Diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We examined the value of spinal cord magnetic resonance imaging (MRI) in the diagnostic work-up of multiple sclerosis (MS). Forty patients suspected of having MS were examined within 24 months after the start of symptoms. Disability was assessed, and symptoms were categorized as either brain or spinal cord. Work-up further included cerebrospinal fluid analysis and standard proton-density, T2-, and T1-weighted gadolinium-enhanced brain and spinal cord MRI. Patients were categorized as either clinically definite MS (n = 13), laboratory-supported definite MS (n = 14), or clinically probable MS (n = 4); four patients had clinically probable MS, and in nine MS was suspected. Spinal cord abnormalities were found in 35 of 40 patients (87.5 %), consisting of focal lesions in 31, only diffuse abnormalities in two, and both in two. Asymptomatic spinal cord lesions occurred in six patients. All patients with diffuse spinal cord abnormality had clear spinal cord symptoms and a primary progressive disease course. In clinically definite MS, the inclusion of spinal imaging increased the sensitivity of MRI to 100 %. Seven patients without a definite diagnosis had clinically isolated syndromes involving the spinal cord. Brain MRI was inconclusive, while all had focal spinal cord lesions which explained symptoms and ruled out other causes. Two other patients had atypical brain abnormalities suggesting ischemic/vascular disease. No spinal cord abnormalities were found, and during follow-up MS was ruled out. Spinal cord abnormalities are common in suspected MS, and may occur asymptomatic. Although diagnostic classification is seldom changed, spinal cord imaging increases diagnostic sensitivity of MRI in patients with suspected MS. In addition, patients with primary progressive MS may possibly be earlier diagnosed. Finally, differentiation with atypical lesions may be improved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050058
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  • 4
    Electronic Resource
    Electronic Resource
    The value of continuous intra-operative EEG monitoring during carotid endarterectomy (1988)
    Springer
    Acta neurochirurgica 91 (1988), S. 95-99 
    Details
    ISSN: 0942-0940
    Keywords: Carotid stenosis ; carotid endarterectomy ; carotid shunt ; EEG monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a retrospective study, an evaluation was made of the intraoperative EEG findings and clinical results of 100 consecutive carotid endarterectomies carried out in 90 patients over the period 1977 to 1983. There was no operation-associated mortality; the peri-operative morbidity was 5%. All operations were performed maintaining the systemic blood pressure some 20% above the patients normal value. No interval shunt was used. The surgical policy was not influenced by EEG findings in any of the procedures. There was no relationship between carotid-clamping time and intra-operative EEG changes, nor was there a relationship between EEG changes and clinical outcome. It is most likely that neurological deficit following carotid endarterectomy, if operation is performed during elevated systemic blood pressure, is not due to haemodynamic disturbances, as a consequence of critical reduction of cerebral blood flow during internal carotid artery clamping, but to micro-embolism. From this assumption, it can be concluded that peri-operative complications of carotid endarterectomy cannot be reduced by intra-operative EEG monitoring.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01424561
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Low-dose Cyclosporin A Induces Relapsing Experimental Allergic Encephalomyelitis in the Lewis Rat (1988)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 540 (1988), S. 0 
    Details
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1749-6632.1988.tb27168.x
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  • 6
    Electronic Resource
    Electronic Resource
    Cerebrospinal fluid cells in multiple sclerosis and other neurological diseases: an immunocytochemical study (1987)
    Springer
    Journal of neurology 234 (1987), S. 19-22 
    Details
    ISSN: 1432-1459
    Keywords: Cerebrospinal fluid ; Monoclonal antibodies ; Mononuclear cell subsets ; Multiple sclerosis ; Neurological disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Determinations of mononuclear cell subsets in cerebrospinal fluid (CSF), using monoclonal antibodies against surface antigens which identified pan T-cells, helper/inducer T-cells, cytotoxic/suppressor T-cells and Ia-positive cells, were performed in patients with multiple sclerosis (MS), other neuroimmunological diseases (NID), infectious diseases (INF) of the central nervous system and with other neurological diseases. Whereas there was an elevated helper T/suppressor T ratio in CSF of patients with NID (Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, cerebral vasculitis), no other significant differences could be detected between the different groups of patients. Our results suggest that analysis of these mononuclear cell subsets in CSF is not helpful in discriminating between MS and other neurological diseases and that in MS patients changes in disease activity are not clearly indicated by fluctuations in the different CSF cell subsets. Further studies will be needed to confirm our findings in NID patients and to understand the diagnostic and theoretical implications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314003
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  • 7
    Electronic Resource
    Electronic Resource
    Fatigue, sleep disturbances and circadian rhythm in multiple sclerosis (1993)
    Springer
    Journal of neurology 240 (1993), S. 446-448 
    Details
    ISSN: 1432-1459
    Keywords: Fatigue ; Sleep ; Circadian rhythm ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to investigate whether fatigue and sleep disturbances in multiple sclerosis (MS) patients might be due to disrupted circadian sleep wake regulation. Actigraphy and a multiple sleep latency test (MSLT) were performed in 16 MS patients with both prominent sleep complaints and fatigue. Actigraphy scores did not differ from control values, whereas sleep onset latency values were altered in subgroups of MS patients. No evidence was found for a generalized circadian disturbance in MS patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00867360
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  • 8
    Electronic Resource
    Electronic Resource
    Serial quantitative MR assessment of optic neuritis in a case of neuromyelitis optica, using Gadolinium-“enhanced” STIR imaging (1991)
    Springer
    Neuroradiology 33 (1991), S. 70-71 
    Details
    ISSN: 1432-1920
    Keywords: MR imaging ; STIR ; Neuromyelitis optica ; Optic nerve ; Gadolinium-DTPA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient is presented with neuromyelitis optica. MR imaging, using a short inversion time inversion recovery (STIR) technique, clearly depicted the lesion in the left optic nerve. Subsequent serial STIR imaging, with and without Gadolinium-DTPA, allowed quantitative assessment of changes parallel to improved optic nerve function. STIR imaging is a sensitive technique to demonstrate optic nerve lesions, and enables quantitative assessment to be made of the effect of (steroid) medication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00593340
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  • 9
    Electronic Resource
    Electronic Resource
    Factor structure of the Disability and Impact Profile in patients with multiple sclerosis (1999)
    Springer
    Quality of life research 8 (1999), S. 141-150 
    Details
    ISSN: 1573-2649
    Keywords: Quality of life ; multiple sclerosis ; disability evaluation ; questionnaires ; factor analysis ; statistical.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The Disability and Impact Profile (DIP) is used for the measurement of quality of life in multiple sclerosis (MS) patients. Data from 211 persons with definite MS from Belgium, Denmark and the Netherlands were used to address three questions. To what extent do the impairment ratings and their complementary weighted scores share common variance? What is the factor structure of the weighted scores? To what extent do disease-related information and information from psychological questionnaires offer concurrent validity for the factors? Correlations between impairment ratings and the weighted item scores were high; for most items the complementary ratings of impact do not supplement information provided by impairment ratings. The DIP weighted scores can be represented to some extent by three independent dimensions: a motor (skeletal movement) or displacement ability factor, a factor relating to sensory–cognitive intactness and a psychological well-being factor. A two-factor solution provides a first factor identical to that of the three-factor solution and a second factor representing psychological well-being. The two factors correlate well with instruments measuring disability and with satisfaction versus emotional distress. Provisional scales based on the factors were constructed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026481029191
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  • 10
    Electronic Resource
    Electronic Resource
    Longterm meningeal involvement as the only clinical manifestation of low grade malignant non-Hodgkin's lymphoma (1990)
    Springer
    Journal of neuro-oncology 9 (1990), S. 275-277 
    Details
    ISSN: 1573-7373
    Keywords: low-grade non-Hodgkin's lymphoma ; leptomeningeal involvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We present the case of a 56-year old man who developed -at the age of 46-paraesthesia and numbness in the perianal region, the feet and lower legs accompanied by the presence of B-lymphocytes in the cerebrospinal fluid (CSF). Despite intensive work-up an explanation was not found until he developed hepato-splenomegaly ten years after the initial symptoms. Haematologic evaluation at that time disclosed a low-grade malignant B-cell lymphoma. Repeated CSF examination revealed 31 leukocytes/mm3, of which were mainly lymphocytes. These proved to be B-lymphocytes of monoclonal origin. These findings suggest that a leptomeningeal localisation of a low-grade malignant lymphoma had been present for ten years before systemic manifestation of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02341158
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