MultipleSclerosis

Stream HIV and multiple sclerosis: beginning to unravel a mystery by BMJ talk medicine from desktop or your mobile device  

Stream Diagnosing and treating neuromyelitis optica by BMJ talk medicine from desktop or your mobile device  

Dimethyl fumarate was approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency for adults with relapsing-remitting multiple sclerosis (RRMS). It does not require that any other medication be tried before dimethyl fumarate is prescribed. Although data from non Cochrane reviews are available, it is important to systematically evaluate its efficacy and safety as monotherapy versus placebo.  

Does telerehabilitation achieve better outcomes in persons with multiple sclerosis compared with traditional face-to-face intervention? What types of telerehabilitation interventions are effective, in which setting and influence which specific outcomes?  

 

Nicola Smith, who has multiple sclerosis, tells the Victoria Derbyshire programme she is worried that her condition will lead her son to miss out.  

To evaluate the potential of quantitative susceptibility (QS) and R2* mapping as surrogate biomarkers of clinically relevant, age-adjusted demyelination and iron deposition in multiple sclerosis (MS).  

The cerebrospinal fluid (CSF) is produced from arterial blood by the choroid plexuses of the lateral and fourth ventricles by a combined process of diffusion, pinocytosis and active transfer. A small amount is also produced by ependymal cells. The choroid plexus consists of tufts of capillaries with thin fenestrated endothelial cells. These are covered by modified ependymal cells with bulbous microvilli. The total volume of CSF in the adult ranges from140 to 270 ml. The volume of the ventricles is about 25 ml. CSF is produced at a rate of 0.2 - 0.7 ml per minute or 600-700 ml per day. The circulation of CSF is aided by the pulsations of the choroid plexus and by the motion of the cilia of ependymal cells. CSF is absorbed across the arachnoid villi into the venous circulation and a significant amount probably also drains into lymphatic vessels around the cranial cavity and spinal canal. The arachnoid villi act as one-way valves between the subarachnoid space and the dural sinuses. The rate of absorption correlates with the CSF pressure. CSF acts as a cushion that protects the brain from shocks and supports the venous sinuses (primarily the superior sagittal sinus, opening when CSF pressure exceeds venous pressure). It also plays an important role in the homeostasis and metabolism of the central nervous system.