Progressive multiple sclerosis – characteristic features, course and prognosis Review article
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Published:
Dec 31, 2015
Keywords:
multiple sclerosis, primary progressive MS, progression, ocrelizumab
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Abstract
About 10–15% of patients with multiple sclerosis (MS) present with progressive neurological disability; that clinical course of the disease is known as primary-progressive multiple sclerosis (PPMS). Patients with PPMS are older at onset in comparison with relapsing-remitting course of the disease. Inflammatory white-matter lesions are not so evident and axonal degeneration is dominant. MRI of the brain and spinal cord, and examination of the cerebrospinal fluid are important for diagnosis. Conventional immunomodulatory drugs are not effective. Finding the mechanisms of the PPMS development is crucial to effective therapy.
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References
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2. Losy J.: Stwardnienie rozsiane. Wydawnictwo Czelej, Lublin 2013.
3. Selmaj K.: Stwardnienie rozsiane. Termedia, Poznań 2006.
4. Weinshenker B., Bass B., Rice G. et al.: The natural history of multiple sclerosis: a geographically based study. 1. Clinical course and disability. Brain 1989; 112: 133-146.
5. Lublin F., Reingold S.: Defining the clinical course of multiple sclerosis: results of an international survey. Neurology 1996; 46: 907-911.
6. Kurtzke J.: Rating neurological impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444-1452.
7. Confavreux Ch., Compston A.: The natural history of multiple sclerosis. McAlpines’s Multiple Sclerosis. Churchill Livingston 2005.
8. Wolinsky J.; the PROMiSe Study Group: The diagnosis of primary progressive multiple sclerosis. J. Neurol. Sci. 2003; 206: 145-152.
9. Filippi M., Rovaris M., Rocca M.: Imaging primary progressive multiple sclerosis: the contribution of structural, metabolic, and functional MRI techniques. Mult. Scler. 2004; 10(supl. 1): S36-44.
10. Lycklama G., Thompson A., Filippi M. et al.: Spinal-cord MRI in multiple sclerosis. Lancet Neurol. 2003; 2: 555-562.
11. Tremlett H., Paty D., Devonshire V.: The natural history of primary progressive MS in British Columbia, Canada. Neurology 2005; 65: 1919-1923.
12. Kremenchutzky M., Rice G., Baskerville J. et al.: The natural history of multiple sclerosis: a geographically based study 9: observations on the progressive phase of the disease. Brain 2006; 129: 584-594.
13. Confavreux C., Vukusic S.: Age at disability milestones in multiple sclerosis. Brain 2006; 129: 595-605.
14. Lycklama G., Nijeholt G., van Walderveen M. et al.: Brain and spinal cord abnormalities in multiple sclerosis: correlation between MRI parameters, clinical subtypes and symptoms. Brain 1998; 121: 687-697.
15. Bieniek M., Altmann D., Davies G. et al.: Cord atrophy separates early primary progressive and relapsing remitting multiple sclerosis. J. Neurol. Neurosurg. Psychiatry 2006; 77: 1036-1039.
16. McDonald W., Compston A., Edan G. et al.: Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann. Neurol. 2001; 50: 121-127.
17. Polman Ch., Reingold S., Banwell B. et al.: Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann. Neurol. 2011; 69: 292-302.
18. Leary S., Miller D., Stevenson V. et al.: Interferon beta-1a in primary progressive MS: an exploratory, randomized, controlled trial. Neurology 2003; 60: 44-51.
19. Montalban X.: Overview of European pilot study of interferon beta-1b in primary progressive multiple sclerosis. Mult. Scler. 2004; 10(supl. 1): S62-64.
20. Wolinsky J., Narayana P., O’Connor P. et al.: Glatiramer acetate in primary progressive multiple sclerosis: results of a multinational, multicenter, double-blind, placebo-controlled trial. Ann. Neurol. 2007; 61: 14-24.
21. Lublin F., Reingold S., Cohen J. et al.: Defining the clinical course of multiple sclerosis. Neurology 2014; 83: 278-286.