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Saturday, September 12, 2009

Common Treatments for Multiple Sclerosis

Source for this posting: WebMd


For those with MS see :Today on WebMD video"

Show or hide information about video: Yoga for MS Yoga for MS

Yoga’s healing powers are now helping

MS patients lead happier, healthier lives.

Watch Video: Yoga for MS (opens in a new window)

Show or hide information about video: Future of MS Treatment Future of MS Treatment

Show or hide information about video: Mothers with MS Mothers with MS

Show or hide information about video: Multiple Sclerosis and Exercise Multiple Sclerosis and Exercise

Show or hide information about video: Reducing Urinary Incontinence Reducing Urinary Incontinence


For Newly Diagnosed: Questions to Ask Your Doctor About MS

Source: WebMd

Questions to Ask Your Doctor About MS
If you are newly diagnosed with multiple sclerosis, you will have plenty of questions.

When you click the above link, you will find

Multiple Sclerosis: Frequently Asked Questions


Patients using Avonex have few site reactions

Source: Huliq News
Sept 12, 2009

Data from an observational phase IV study of 499 patients entitled The Swiss MS Skin Project show that multiple sclerosis (MS) patients taking AVONEX (interferon beta-1a IM) reported significantly fewer injection site reactions (ISRs) compared to patients on Betaferon® (interferon beta-1b), Copaxone® (glatiramer Acetate) or Rebif ® (interferon beta-1a).

The study also showed AVONEX patients were less likely to have missed a dose due to an injection site reaction in the four weeks prior to first assessment than those patients on other interferon therapies. These data were presented as a poster at the 25th Annual European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) meeting in Düsseldorf, Germany.

"This study showed that treatment with AVONEX leads to fewer injection site reactions which is an important factor in improving compliance. As the only once-weekly injection treatment, AVONEX offers people with relapsing MS an easy-to-use and highly effective treatment option," said Dr. Karsten Beer, lead investigator for the study and private neurologist in Wil, Switzerland. "Convenience of an MS therapy is an important consideration for patients, as they do not want a therapy that will interfere with their daily lives."

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Clinical MS Trial Basics and listings of current trial studies

Clinical trials help to determine if a drug is safe and effective for people with MS. People with MS who are willing to volunteer in these studies make it possible for all of us to look forward to new and better therapies.

Clinical Trial Basics

The process is complicated. Many factors are involved in making sure that a study is conducted properly and that the results are valid. The U.S. Food and Drug Administration requires therapies to undergo three phases of clinical trials before they can be approved to treat people with MS:

  • Phase I – The first step is to determine safety. In a small number of healthy volunteers or persons with MS, the investigators determine how the human body reacts to the therapy.
  • Phase II – If the therapy proves to be safe, studies begin to determine the effectiveness of the drug in people with MS. These studies may last several months or several years, and involve larger numbers of people. The study is "controlled"—that is, the drug is compared with the standard treatment, or an inactive placebo.
  • Phase III – If an MS drug shows effectiveness, an even larger study is conducted in hundreds of people to gain a better understanding of the drug’s effectiveness and possible side effects. These multi-center studies can span several years and several countries.

Following FDA approval, post-marketing studies (phase IV) might be conducted to assess long-term safety and effectiveness.

Participate in Clinical Trials

People with MS can take an active role in freeing the world of MS by participating in drug studies. Find out about local studies and what you need to know before you participate.

Clinical Trial FAQs

What you need to know before you participate.

Clinical Trials in MS 2009 (.pdf)

There are now 129 ongoing, planned, or recently completed clinical trials in multiple sclerosis, according to Clinical Trials in MS 2009 (.pdf), a list compiled by the National MS Society. These studies are bringing new hope for oral drugs, better options for people with progressive MS, and novel approaches to alleviating symptoms. For recent results of MS research, including clinical trials, see Research News.

Glossary of Clinical Trial Terms

Some terms commonly used related to clinical studies.

Additional Clinical Trial Resources

More listings of ongoing MS studies and general information on participation in clinical research.

SOURCE: National MS Society Clinical Trials


Friday, September 11, 2009

Flu Vaccine and H1N1 (Swine Flu) Vaccine Information for 2009-2010

Source: National MS Society
September 11, 2009

Regular flu shot: As in previous years, the National MS Society recommends a regular flu shot as a safe and effective vaccination for people with MS. The flu shot—which is a de-activated or “killed” vaccine—can safely be taken by individuals who are on any of the disease-modifying medications (Avonex®, Betaseron®, Copaxone®, Rebif®, Novantrone®, or Tysabri®).

FluMist Intranasal®: In 2003, the FDA approved a flu vaccine nasal spray “for healthy children and adolescents, ages 5-17, and healthy adults, ages 18-49.” According to Dr. Aaron Miller, the Society’s Chief Medical Officer, FluMist—which is a live, weakened vaccine—is not recommended for use by people with MS, and should specifically be avoided by any person with MS who is on an immunosuppressive medication such as mitoxantrone (Novantrone®), cyclophosphamide (Cytoxan®), azathioprine (Imuran®), or methotrexate.

  • Live-virus vaccines are more likely than de-activated-virus vaccines to cause an increase in disease activity in people with MS.
  • A person taking an immunosuppressive medication is more susceptible to developing an infection with the vaccine strain of the virus—an infection that may be particularly severe because the person’s immune system is suppressed.
  • The interactions between live vaccines and the disease-modifying medications are not known.

H1N1 (Swine Flu) vaccine: The H1N1 (Swine Flu) vaccine is still in production, so its safety and efficacy have not yet been established.

Click here to continue


Asymptomatic reactivation of JC virus in patients treated with natalizumab

Asymptomatic reactivation of JC virus in patients treated with natalizumab

Natalizumab is the most recently approved treatment for MS. Its efficacy has been demonstrated in clinical trials and practice. However, despite these clinical effects, there is a risk of progressive multifocal leukoencephalopathy (PML), which can result in death or severe disability. Therefore its use has been restricted to people with a non- satisfactory response to first line treatments, such as interferon beta and glatiramer acetate. PML occurs after a reactivation of the common JC virus, which remains latent in the kidney and lymphoid organs, after infection. The mechanisms by which this reactivation may occur in people receiving natalizumab are unclear. The authors studied a group of people with MS receiving natalizumab treatment. The main findings of the study were that evidence of potential JC virus reactivation were discovered, as the virus was detected in the urine samples of more than half of the study population after one year of treatment. In addition, after one and a half years, the JC virus was detected in the blood samples of a fifth of the population. None of the participants suffered from PML during the study. Although the mechanisms underlying the reactivation of JC virus remain unclear, these results shed new light on these issues, which might help to design new algorithms for the management of people with MS on natalizumab in order to avoid PML developing.

authors: Chen Y, Bord E, Tompkins T, Miller J, Tan CS, Kinkel RP, Stein MC, Viscidi RP, Ngo LH, Koralnik IJ

source: N Engl J Med. 2009 Sep 10;361(11):1067-74

read more


Genzyme’s Alemtuzumab for Multiple Sclerosis Shows Durable Treatment Benefit in Review of Four-Year Phase 2 Trial Data

Genzyme Corporation (Nasdaq: GENZ) reported today that four-year follow-up data from its completed Phase 2 multiple sclerosis (MS) trial continued to show durable reductions in relapse rate and sustained accumulation of disability three years after the majority of patients received their last course of the investigational compound alemtuzumab.

The CAMMS223 Phase 2 trial compared alemtuzumab to an approved MS therapy Rebif® (interferon beta-1a) in early, relapsing-remitting multiple sclerosis (RRMS) patients who had received no prior therapy. The accumulated four-year efficacy and safety data from the Phase 2 trial will be presented today in Germany at theEuropean Committee for Treatment and Research in Multiple Sclerosis(ECTRIMS) annual meeting, one of the largest annual international MS conferences. Three-year CAMMS223 trial data were reported in the New England Journal of Medicine (NEJM) last October.

"These longer-term Phase 2 data showed durable reductions in the occurrence of relapses and the accumulation of disability, extending for several years after patients’ last treatment,” said Alasdair Coles, MD, Senior Lecturer, Department of Clinical Neurosciences, University of Cambridge, a lead investigator of the Phase 2 clinical trial. "These findings confirm the extended duration of response observed in our pilot studies with alemtuzumab in patients with relapsing MS.”


*** Media Alert *** - Survey of Health Care Providers and People Living with Relapsing Multiple Sclerosis Reveals Unmet Treatment Need

The National Multiple Sclerosis (MS) Society, in collaboration with EMD Serono, announced a poster presentation, “MS Viewpoints: Outlook on Emerging MS Therapies,” at the 25th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). The MS Viewpoints survey was conducted to evaluate the perceptions of health care professionals and people living with relapsing MS.

Key findings presented in the poster at ECTRIMS include:
· 41% of people living with relapsing MS reported feeling anxious about needles or intravenous therapy
· Nearly 20% of people with relapsing MS reported delaying prescribed therapy. Of those who delayed therapy, 29% did not start treatment for more than 1 year
· 68% of neurologists believed patients would initiate therapy sooner if an oral medication were available

Current treatment recommendations indicate that treatment should be started immediately following definitive diagnosis.1,2 Oral administration of MS treatments, MS Viewpoints found, is a desired improvement to MS therapy.

» Read More


New Data from CLARITY Study on Disease Activity in MS Patients

September 11, 2009

New Data from CLARITY Study on Disease Activity in MS Patients
Who Received Cladribine Tablets Presented at 25th ECTRIMS Congress

· Post-hoc analysis from CLARITY study show that short-course oral treatment with Cladribine Tablets significantly increased the proportion of patients who had absence of disease activity compared with placebo

Düsseldorf, Germany, and Geneva, Switzerland,
September 11, 2009 – Merck Serono, a division of Merck KGaA, Darmstadt, Germany, announced new data from a post-hoc analysis of the two-year (96-week) placebo-controlled CLARITY1 Phase III trial using a short-course of Cladribine Tablets (Merck Serono’s proprietary investigational oral formulation of cladribine) to treat patients with relapsing-remitting multiple sclerosis (MS). The data from this post-hoc analysis of the CLARITY study were presented at the 25th congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Düsseldorf, Germany.2

» Read More


Disclosing MS in the workplace

Should You tell? Some considerations about disclosing MS in the workplace

There is no right or wrong answer when it comes to disclosing your condition at work. You have to consider a lot of factors—your health, your career and, if applicable, your family. You need to think about what's best for you. It may help to ask yourself a few key questions first.

  • Are you able to meet the necessary standards of your job?
  • Are you skipping work for medical appointments?
    • Or are you skipping medical appointments for work?
  • Are you getting positive or negative comments on your job performance?
  • Are you able to keep up with the schedule and pace of your work?
Continue reading this article that affects so many, by clicking here

Then, keep up to date with MS related news by registering at our website and viewing this blog, daily.

More favourable results on another Oral MS therapy in testing

LONDON, Sept 11 (Reuters) - Patients given an experimental multiple sclerosis tablet from Sanofi-Aventis (SASY.PA) showed a significant improvement compared to those on placebo in a mid-stage test, researchers said on Friday.

Teriflunomide, which was used as an add-on therapy to interferon beta in the Phase II clinical trial, is one of a number of MS drugs in development that are designed to be given by mouth rather than injection or infusion.

In the 24-week study, patients on the new drug experienced a 56 percent and 81 percent reduction in cerebral inflammatory lesions compared to those on placebo, as measured by MRI scan, on two different doses of the drug, which was well tolerated.

"These results encourage longer-term studies to establish the clinical benefit of combination treatment in this disease where effective new therapies are eagerly awaited," investigator Mark Freedman of the University of Ottawa said in a statement.

Teriflunomide is currently being evaluated in final-stage Phase III studies.


A Little Financial Tip to Survive A Life-Altering Diagnosis

Hi Stuart-

I came across your blog recently and read about your non-profit providing information on MS. Thank you for being willing to share with others who find your blog of support and comfort. Recently I’ve joined efforts with Allsup (“About Us” link) in providing educational information on how others with life-altering diagnoses like MS can gain financial assistance from Social Security Disability Insurance funded through your and my payroll taxes.

Below is a little more information I thought would be helpful to you and your readers who might be considering applying for SSDI as it can be a very difficult process. Feel free to post to your blog whatever portion you think would be helpful.

Please let me know if you have any questions. Once again, thanks for your blogging! I hope this information can be of help to you or your readers and bests of luck with your new medication! Sincerely, Donelle

A Little Financial Tip to Survive A Life-Altering Diagnosis

People who’ve received a life-altering medical diagnosis aren’t alone in the trials and adjustments. The U.S. Census Bureau has recorded more than 54 million Americans who have reported a disease or injury affecting their ability to perform everyday tasks at home and responsibilities at work.

That’s why the government took notice back in the 1950s of the financial struggles Americans were facing and created Social Security Disability Insurance. SSDI is funded through mandatory payroll taxes from your and my paychecks which in return provide monthly subsidies to those impacted by long-term medical diagnosis.

While SSDI has brought relief and hope to millions, there are a few challenges to overcome in the system. In January 2009, almost 3 million individuals who have applied for SSDI are stuck in the system and will wait an average of 2-3 years for assistance!

Overwhelming? Yes. Still, applying for SSDI is one of the best financial steps you can take when a diagnosis like Multiple Sclerosis appears to have long-term impact. These benefits are rightfully yours if you qualify. From Allsup’s website, below are a few suggestions to help the SSDI process move a little quicker:

1. Determine your eligibility for SSDI. A few eligibility guidelines are 1) you’ve received your diagnosis before full-retirement age (65 to 67); 2) you are not working due for reasons like MS; and 3) you have received a taxed paycheck for five of the last 10 years. For a full list of criteria, visit this link to

2. Ask your doctor for a written medical confirmation. At the beginning of your application process, you will need a letter from your doctor confirming the diagnosis and listing the conditions that qualify you for benefits. If you don’t, this can slow the process down a month or more.

3. Meet deadlines. If benefits are denied at any stage of the process, there is only a 60 day window to file an appeal. You don’t want to miss the deadline or else the process starts over from the beginning.

Don’t give up during the application process! Get help early and be persistent. While 60 percent of first-time applicants are denied by the Social Security Administration, it’s also known that two-thirds of applicants who appeal eventual receive their financial assistance. No one could have prepared you for the day the doctor said, “It’s MS,” but there is help available and government funds to give back a little of your stability.

HAVE QUESTIONS? Visit : or call 800.279.4357?

Have something to share with others? If so, please use the post comment link found below. Your name and email address would be appreciated but is not necessary unless you want a response from others. Thank You

New Teva Data Highlights Advances in MS Treatment Research

- Results Presented at Leading Global MS Congress -

JERUSALEM--(BUSINESS WIRE)--Sep 8, 2009 - Teva Pharmaceutical Industries Ltd. (NASDAQ:TEVA) today announced that new research data furthering the clinical understanding of its diverse multiple sclerosis (MS) treatment franchise will be presented at the 25th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Düsseldorf, Germany, September 9-12, 2009. Featured presentations and abstracts will include new data onCOPAXONE®, the global leading treatment for relapsing-remitting multiple sclerosis (RRMS), as well as on the company's compounds in advanced development.

"For nearly two decades Teva has supported the MS community and our ongoing commitment to research and development will continue to provide effective MS treatments while maintaining safety as well as contribute to a greater understanding of the disease,” said Moshe Manor, Teva's Group Vice President, Global Branded Products. “Our dedication has not only brought forth the world's leading MS treatment, COPAXONE®, but we are looking forward to continually support the MS community through our evolving pipeline, led by oral laquinimod.”

>> Continue Reading from

A similar version of this article was posted to this blog on September 8th, but do to a bad link I had to suspend that posting and then post again.. - Sorry for any inconvenience this may have caused.


Two Genes identified by Mayo Clinic as potential therapeutic targets for Multiple Sclerosis

Mayo Clinic identifies 2 genes as potential therapeutic targets for multiple sclerosis
Published Release 11-Sept-2009

Early research holds promise for new therapies and better prediction of patient outcomes

ROCHESTER, Minn. -- A Mayo Clinic study has found that two genes in mice were associated with good central nervous system repair in multiple sclerosis (MS). These findings give researchers new hope for developing more effective therapies for patients with MS and for predicting MS patients' outcomes. This study will be presented at the Congress of the European Committee for Treatment and Research in Multiple Sclerosis in Dusseldorf, Germany, on Sept. 11, 2009.

"Most MS genetic studies have looked at disease susceptibility -- or why some people get MS and others do not," says Allan Bieber, Ph.D., a Mayo Clinic neuroscientist and author of this study. "This study asked, among those who have MS, why do some do well with the disease while others do poorly, and what might be the genetic determinants of this difference in outcome."

Mayo Clinic provides care for nearly 2,500 patients with MS each year.


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UPDATE 1-New data shows promise of German Merck's MS drug

Friday Sept 11, 2009

* 43-44 pct of patients show no disease activity after 2 yrs

* Merck's cladribine leading race to be first oral MS drug

* German drugmaker's shares up 2 pct

(Adds details, shares, background)

LONDON, Sept 11 (Reuters) - A new analysis of data from a clinical trial of Merck KGaA's (MRCG.DE) oral drug cladribine has underscored its potential as a treatment for multiple sclerosis, researchers said on Friday.

The fresh finding from the Phase III trial -- headline results of which were first presented in April -- showed a short course of cladribine tablets significantly increased the proportion of patients without disease activity after two years.

Research presented at the European Committee for Treatment and Research in Multiple Sclerosis congress in Duesseldorf found 43 and 44 percent of patients treated with two different doses of cladribine had absence of disease activity, compared with 16 percent of those on placebo.


Thursday, September 10, 2009

MS ride, will honor former New Bern (NC) man

Sun Journal Staff

The memory of a New Bern man with steadfast commitment to creating a world free of multiple sclerosis will be honored by those riding in this weekend’s Bike MS event.

Officials of the Eastern North Carolina Chapter of the National Multiple Sclerosis Society announced Wednesday that 2009 Bike MS will be dedicated to former New Bern resident John Randell.

Randell, who died Jan. 1, “was a powerful voice in the New Bern community and beyond,” said Staci Barfield, the chapter’s vice president of development in a release.

“No job was too big or too small for John,” she said. “He would clean up trash on the side of the road if needed. When the daunting task of recruiting 50 volunteers for Bike MS arose, he stepped up and took it on. Underneath his rigid, military exterior was a loving, caring, giving man. He volunteered, he advocated, and he always stood up for those enduring challenging circumstances.”

Randell’s wife, Teri, and daughter, Ashleigh Park, both live with multiple sclerosis. During his life, Randell poured many years of service into the National MS Society in an effort to help those affected by multiple sclerosis.

Have something to share with others? If so, please use the post comment link found below. Your name and email address would be appreciated but is not necessary unless you want a response from others. Thank You

Acorda Therapeutics Announces Interim Analysis of Two-Year Efficacy and Safety Data from Phase 3 Fampridine-SR Extension Study

Sept 10, 2009

  • Retention Rate in the Open-Label Study was 82.9% After One Year and 75% After Two Years
  • Sustained Walking Speed Improvement Seen After Two Years in Responder Group

HAWTHORNE, N.Y.--(BUSINESS WIRE)--Sep. 10, 2009-- Data from a long-term open-label extension study from the first Phase 3 Fampridine-SR trial, known as MS-F203, showed that 24.9% of extension study participants with multiple sclerosis (MS) met the criteria as Extension Timed Walk Responders (ETWRs) after one year of treatment and demonstrated improved walking speed over a two year period. In addition, the safety profile of Fampridine-SR observed over two years in this study was consistent with previous placebo-controlled trials. The data were presented today at the 25th Congress of the European Committee for Multiple Sclerosis (ECTRIMS) in Düsseldorf, Germany.

“Long-term data for Fampridine-SR are important because this medicine is potentially a chronic therapy for people with multiple sclerosis,” said Andrew Goodman, M.D., Director of the Multiple Sclerosis Center at the University of Rochester, who presented the data. “The data suggest that Fampridine-SR can produce a sustained, clinically meaningful improvement in walking speed for a subset of people with MS over a two year period.”

Trial Design

In the 14-week placebo-controlled portion of the MS-F203 study, 34.8% of subjects were defined as Timed Walk Responders in the Fampridine-SR group compared to 8.3% of subjects in the Placebo group. Following the placebo-controlled study, 269 of the 283 participants who completed the study, including those defined as Timed Walk Responders, Non-Responders and participants from the Placebo group, enrolled in the open-label extension study. All participants in the extension study were treated with Fampridine-SR at 10 mg twice daily, and assessed in the clinic at 2, 14, 26, 52, 78 and 104 weeks.

Timed walk response in the extension study was defined as walking faster in the majority of the first four open-label visits (2, 14, 26 and 52 weeks) compared to the fastest off-treatment speed, which was measured at seven separate time points during the placebo-controlled trial and at screening for the extension study. Walking speed was measured using the Timed 25-Foot Walk (T25FW).

As of the cut-off date for this analysis (November 30, 2008), participants had been treated with Fampridine-SR for up to 3 years, with an average exposure of 2.1 years and a total exposure of 565 patient-years. More than half of the study participants were diagnosed with secondary-progressive MS (52.8%), with the remainder of diagnosed with relapsing-remitting MS (28.6%), primary-progressive MS (14.9%) or progressive relapsing MS (3.7%).

for Safety and Efficacy Results and additional information, click here


Biotech Center ready for $10.4M expansion

Construction set to start next month on addition to support job-creation initiatives

By Monica Chen; 419-6636

DURHAM -- The N.C. Biotechnology Center is embarking on a $10.4 million addition to its headquarters in Research Triangle Park that will provide 20,000 square feet of new office and conference space.

The addition will support a number of new job-creation initiatives in biotechnology leadership, entrepreneurship, K-12 education, work force training, business development and university research programs. In addition, the expanded facility will continue to play host to an estimated 35,000 visitors annually, according to the Biotech Center.

The four-story structure will be the first addition to the center since founding in 1984. The original 47,000-square-foot center was built to house 50 employees. It's now pushing 65.

Continue to read this story and how it will help boost Raleigh's Local economy as well.


Wednesday, September 9, 2009

Home Safety - written by Susan Dorne, OT

Shmoozin' with Susan

One of the biggest concerns I have as a health care professional is the safety of people. It’s amazing how many barriers are around us, many of which we are not aware of. For people without deficits, they can usually maneuver around obstacles with little or no harm or even thought for that matter. However, when you have MS and your vision, mobility, balance, strength, endurance, and sensation may be affected, consequences are often inevitable. It never ceases to amaze me when people reply “I Know But…” when I try to address potential safety risks and make recommendations.

PLEASE RETURN to this Blog Page to leave comments- thank you


Tuesday, September 8, 2009

Tratamiento Sintomático de Esclerosis Múltiple

La EM es una enfermedad con una importante "carga" sintomática y con una variedad de síntomas muy extensa (dependiendo del área del Sistema Nervioso Central comprometida).

Dentro del ranking de síntomas que más molestan a los pacientes, uno de los más frecuentes es la disminución de fuerzas en las piernas o brazos, seguido de la fatiga. Otros síntomas frecuentes son la falta de equilibrio (en ocasiones asociadas con temblor); alteraciones esfinterianas, disfunción sexual (dificultad en la erección, disminución del deseo sexual, anorgasmia, etc.) y alteraciones visuales (tanto relacionadas con disminución de la visión como visión doble). Las alteraciones sensitivas también pueden presentarse, tanto sea una alteración de la sensibilidad (hormigueos) como también la disminución (en ocasiones pérdida) de la misma. Relacionado con lo anterior, el dolor constituye también un síntoma relativamente frecuente.

A continuación se describirán las estrategias de tratamiento para algunos síntomas de EM:

Fatiga: Afecta al 75-95 % de las personas con EM y muchas veces es el más invalidante. Se define a la fatiga como "la falta subjetiva de energía física o mental percibida por el paciente y que interfiere con las actividades usuales y deseadas..." Tiene un predominio vespertino y generalmente aumenta con la exposición a altas temperaturas. No existe un tratamiento único y definitivo. Lo primero es establecer un exhaustivo programa de reorganización de las tareas cotidianas para realizar un "ahorro" de energía. Existen fármacos que han demostrado su utilidad en la fatiga por EM. La amantadina y la pemolina son dos de los descriptos. La 4 aminopiridina es otra medicación que ofrece buenos resultados. Recientemente, una nueva medicación llamada Modafinil también parece tener resultados positivos. Deberán considerarse otros elementos que pueden aumentar la sensación de cansancio para ser corregidos (depresión, insomnio, hábito de fumar, consumo de tranquilizantes, etc.)

Espasticidad: Se define como un aumento exagerado del tono muscular y se manifiesta como una "dureza" o "rigidez" de los miembros. No es un síntoma exclusivo de la EM. En muchos casos un determinado grado de espasticidad constituye un elemento importante para mantener la función (caminar), sobre todo cuando la fuerza está disminuida. Por lo tanto es importante remarcar que lo que se debe lograr es un adecuado "manejo" de la espasticidad, mas que un tratamiento que la elimine por completo.

En primer lugar se deben identificar y tratar las complicaciones clínicas generales (por ej. una infección urinaria) o locales (por ej. una uña encarnada) que pueden llegar por si solo a incrementar el grado de espasticidad. El paso siguiente es un adecuado manejo físico (terapia kinesiológica) con técnicas de elongación y estiramiento. Si con lo anterior no se logró un buen manejo del síntoma recién allí se indican fármacos antiespásticos. Los más conocidos son el Baclofén y la Tizanidina. Otros relajantes musculares como el Diazepam pueden utilizarse. En casos de espasticidad severa y localizada se utiliza también la Toxina botulínica tipo A. Casos seleccionados pueden requerir la administración de baclofén a través de una bomba de infusión intratecal. El tratamiento quirúrgico de la espasticidad en EM es algo que en la actualidad está limitado solo a situaciones excepcionales.

A modo de ejemplo se ha considerado el manejo de dos de los síntomas habituales pero deberá tenerse en cuenta que cada uno de los problemas que causa la EM tiene un tratamiento que permitirá su alivio.

Una consideración especial requiere la rehabilitación integral dentro del tratamiento de la EM, pues sin duda es un eje importante del manejo cotidiano de estos pacientes. Rehabilitación integral no significa solo trabajo o ejercicio físico. La complejidad y variabilidad de los síntomas requiere de un Equipo Interdisciplinario que logre el verdadero objetivo de la rehabilitación que no es otro que el desarrollo del máximo de las potencialidades que siempre tiene el paciente. Es importante que el trabajo sea encarado por un equipo con experiencia en el tema para no malgastar esfuerzos y no agregar nuevas complicaciones.


Video updates from European Committee for Treatment Research in Multiple Sclerosis

Dr Daniel Kantor, Medical Director, Neurologique, USA, will be filming daily bulletins for MS World from the European Committee for Treatment Research in Multiple Sclerosis (ECTRIMS) congress, Düsseldorf, Germany from 9 -12 September 2009.

To learn more and watch the video updates from the world's largest annual international medical conference dedicated to MS research click here.

Dr Kantor will answer selected questions in his daily video updates. To ask him a question e-mail:

Source: MS World

Intrathecal antibody production against Epstein-Barr and other neurotropic viruses in pediatric and adult onset multiple sclerosis

MS is a complex disease of autoimmune origin with an unknown cause. Viruses may play a role in the pathogenesis of the disease, for example Epstein-Barr virus (EBV), a virus with a special ability to reach the central nervous system. The authors aimed to investigate to what extent EBV is involved in the pathogenesis of MS by comparing the frequency and intensity of antibody production within the central nervous system (CNS) against EBV, with the antibody production against other viruses also known for their ability to reach and involve the CNS (i.e. neurotropic viruses).

Since the authors found that the production of antibodies within the CNS against EBV was not higher than the production against other neurotropic viruses, the results of this study do not support the theory that EBV has a direct role in the pathogenesis of the disease. However, evidence from previous studies suggests that EBV may play a role in MS.

Therefore because the results of this study do not exclude an indirect pathogenic mechanism mediated by EBV, more studies are required.

authors: Pohl D, Rostasy K, Jacobi C, Lange P, Nau R, Krone B, Hanefeld F

source: J Neurol. 2009 Aug 28

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