scholarly journals A Pediatric Case of Relapsing-Remitting Multiple Sclerosis Onset following Varicella Zoster Ophthalmicus with Optic Neuritis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Naoko Shiba ◽  
Yuji Inaba ◽  
Mitsuo Motobayashi ◽  
Makoto Nishioka ◽  
Yoichiro Kawasaki ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Herpes Zoster ◽  
Optic Neuritis ◽  
Trigeminal Nerve ◽  
Present Report ◽  
Epidemiological Studies ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis

Some epidemiological studies have implied a pathogenetic association between varicella zoster virus (VZV) and multiple sclerosis (MS); this, however, remains controversial. The present report describes a case involving an immunocompetent 10-year-old girl who developed relapsing-remitting MS following the prolonged reactivation of VZV inside the first branch of the trigeminal nerve, exhibiting herpes zoster ophthalmicus with severe optic neuritis. Symptoms related to herpes zoster ophthalmicus and MS appeared consecutively in the 10-week period after the appearance of vesicles. This suggests that the onset of MS was triggered by some mechanism involving VZV reactivation in the first branch of the trigeminal nerve. To the best of our knowledge, this report is the first to describe a relationship between the onset of MS and herpes zoster ophthalmicus. Early diagnosis and aggressive antiviral therapy are important in cases of herpes zoster ophthalmicus to prevent the possible development of MS as well as visual impairment as sequela.

LONG-TERM SAFETY OF ALEMTUZUMAB IN RELAPSING-REMITTING MULTIPLE SCLEROSIS: PREGNANCY AND INFECTION DATA FROM A COHORT OF PATIENTS ON OPEN LABEL STUDIES IN CAMBRIDGE

2015 ◽  
Vol 86 (11) ◽  
pp. e4.15-e4
Author(s):  
Claire McCarthy ◽  
Orla Tuohy ◽  
Laura Azzopardi ◽  
Onajite Kousin-Ezewu ◽  
Joanne Jones ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Varicella Zoster Virus ◽  
Open Label ◽  
Varicella Zoster ◽  
Serious Infections ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

BackgroundAlemtuzumab is recently licensed for use in active relapsing-remitting multiple sclerosis (RRMS) in Europe and the USA. This observational cohort study investigated the long term safety of alemtuzumab in RRMS.MethodsClinical data was collected from a cohort of 87 patients who participated in open label studies of alemtuzumab in Cambridge, UK from 1999 to 2012. Pregnancy outcomes and the occurrence of moderate to severe infections were recorded.ResultsOver a median 7-year follow-up (range 33–144 months), no serious infections occurred that required hospitalisation. There were 11 cases of varicella zoster virus reactivation and one case of primary varicella zoster virus infection. In this cohort 15 babies were born to 12 women treated with alemtuzumab. The median interval from their most recent alemtuzumab treatment to birth was 26 months (range 13–86 months). All of the babies were healthy and delivered without complications. One woman had experienced a miscarriage at 8 weeks gestation but went on to have two successful pregnancies.ConclusionsDuring prolonged follow-up of this cohort of patients treated with alemtuzumab no serious infections occurred. No increased risk of miscarriage or foetal abnormality was seen in the small number of pregnancies studied.

scholarly journals Conversion of Optic Neuritis to Relapsing Remitting Multiple Sclerosis: A Retrospective Comorbidity Cohort Study

2020 ◽  
Vol 83 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Mesrure Koseoglu ◽  
Mesude Tutuncu
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Genetic Factors ◽  
Clinical Relapse ◽  
Bilateral Involvement ◽  
Relapsing Remitting ◽  
Unilateral Involvement ◽  
Involvement Rate ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Turkish Patients

Objective: The aim of the study was to determine the risk of multiple sclerosis (MS) conversion after optic neuritis (ON) and to identify the predictive factors on conversion in Turkish patients. Methods: Patients whose first clinical attacks had been ON were included in the study. The primary end point was the diagnosis of clinical relapse-remitting MS. Result: Except for the bilateral involvement rate, the clinical and demographic characteristics of the cohort are similar to Western studies. Though one-third of the patients with ON had bilateral involvement, bilateral involvement reduces the risk of conversion. Also, active lesions at the initial cranial magnetic resonance imagination increase the conversion rate. Conclusion: This research confirms previous findings and contributes additional evidence that if the patients have unilateral involvement and active lesions, they should be closely monitored. Moreover, our research supports the hypothesis that risk factors may be affected by racial, environmental, and genetic factors.

scholarly journals Herpes zoster ophthalmicus at a tertiary health facility, South-western Nigeria: Clinical presentations and outcome

2020 ◽  
Vol 6 (3) ◽  
pp. 333-337
Author(s):  
O Fasina ◽  
SJ Hughes
Keyword(s):  
Herpes Zoster ◽  
Health Facility ◽  
Trigeminal Nerve ◽  
Significant Proportion ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Clinical Presentations ◽  
Immunodeficiency Virus ◽  
Antiviral Medications ◽  
Type 3

Herpes zoster ophthalmicus is a neurocutaneous disease caused by the human alpha herpes virus Type 3 and it is characterized by reactivation of dormant varicella-zoster virus lying within the trigeminal ganglia. The objective of this study was to describe the clinical presentation and management outcome of patients with herpes zoster ophthalmicus in a tertiary health facility. This was a retrospective study of patients with herpes zoster ophthalmicus managed at the Eye Clinic of a tertiary health facility in the South-western part of Nigeria over eight years. There were 17 patients, comprising five males and the mean age at presentation was 54.9±13.7 years. Seven (41.2%) patients were seropositive for the Human Immunodeficiency Virus (HIV) while nine (52.9%) patients had corneal involvement. Fifteen (88.2%) patients had involvement of the first branch of the trigeminal nerve (V1), and one (5.9%) patient each had involvement of the second branch of the trigeminal nerve (V2) and the first two branches of the trigeminal nerve (V1 and V2). All the patients were managed with oral and topical antiviral medications. Ten patients (58.8%) developed postherpetic neuralgia. In conclusion, Herpes zoster ophthalmicus is strongly associated with HIV seropositivity and older age and a significant proportion of patients develop post-herpetic neuralgia necessitating long term management.

Fatigue predicts disease worsening in relapsing-remitting multiple sclerosis patients

2016 ◽  
Vol 22 (14) ◽  
pp. 1841-1849 ◽  
Author(s):  
Michele Cavallari ◽  
Miklos Palotai ◽  
Bonnie I Glanz ◽  
Svetlana Egorova ◽  
Juan Carlos Prieto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Severe Disability ◽  
Study Cohort ◽  
Relapsing Remitting ◽  
Subsequent Conversion ◽  
Remitting Multiple Sclerosis ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis

Background: It is unclear whether fatigue is a consequence or a predictive trait of disease worsening. Objective: To investigate the predictive value of fatigue toward conversion to confirmed moderate–severe disability in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: We retrospectively selected from the Comprehensive Longitudinal Investigations in MS at the Brigham and Women’s Hospital (CLIMB) study cohort RRMS patients who converted to confirmed (⩾2 years) Expanded Disability Status Scale (EDSS) score ⩾3 within a follow-up period ⩾3 years. We contrasted the Modified Fatigue Impact Scale (MFIS) score of 33 converters, obtained at least 1 year before conversion to EDSS ⩾3, with that of 33 non-converter RRMS patients matched for baseline characteristics. Results: Total MFIS score was higher in converter versus non-converter MS patients (median 37 vs 13; p < 0.0001). EDSS and Center for Epidemiological Studies Depression scale (CES-D) scores were also higher in the converters (median EDSS 1.5 vs 0, p < 0.0001; median CES-D 30 vs 24, p < 0.0001) and were both associated with MFIS score (EDSS: rho = 0.42, p = 0.0005; CES-D: rho = 0.72, p < 0.0001). After adjusting for EDSS and CES-D in multivariate analysis, MFIS remained a significant predictor of subsequent conversion to confirmed EDSS ⩾3. Conclusion: Fatigue is a promising indicator of risk for conversion to confirmed moderate–severe disability in RRMS patients.

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