Townsville Neurosciences

The hyperdense internal carotid artery sign: prevalence and prognostic relevance in stroke thrombolysis.

This study suggests that the prevalence of the HICAS may be lower than previously reported. The presence of a HICAS was associated with severe prethrombolysis neurological deficits in keeping with terminal ICA occlusion. The role of the HICAS as a prognostic marker in stroke thrombolysis remains unclear.

Circle of Willis variation in a complex stroke presentation: a case report.

The case illustrates the complex presentation of stroke as a pseudo-cervical cord lesion and the impact of circle of Willis anatomical variation upon the expression of large vessel cerebrovascular disease.

Time- and Region-Specific Season of Birth Effects in Multiple Sclerosis in the United Kingdom.

Season of birth is a risk factor for MS in the United Kingdom and cannot be attributed to the background pattern in the general population. The reasons for the variations in birth rates in the general population are unclear, but not taking them into consideration could lead to false-positive associations.

Status of diagnostic approaches to AQP4-IgG seronegative NMO and NMO/MS overlap syndromes.

The diagnosis in AQP4-IgG-negative NMO/MS overlap syndromes is challenging and diverse. The classification of such patients currently requires new diagnostic categories, which incorporate lesser degrees of diagnostic confidence. Long-term follow-up may identify early features or biomarkers, which can more accurately distinguish the underlying disorder.

A new era in the treatment of multiple sclerosis.

 While a cure for MS remains elusive, the potential to reduce inflammatory disease activity by preventing relapses and minimising disease progression is achievable. The importance of early treatment in minimising long-term disability is increasingly recognised. Most of the newer, more effective therapies are associated with risks and practical problems that necessitate an active management strategy and continuous vigilance.

Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 1 historical and established therapies. MS Neurology Group of the Australian and New Zealand Association of Neurolog

In this three part series we review the practicalities, benefits and potential hazards of each of the currently available and emerging treatment options for MS. In Part 1 we review the history of the development of MS therapies and its connection with the underlying immunobiology of the disease.

Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of

In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs.

Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 3 treatment practicalities and recommendations. MS Neurology Group of the Australian and New Zealand Association of

In this third and final part of our review of multiple sclerosis (MS) treatment we look at the practical day-to-day management issues that are likely to influence individual treatment decisions.

Effectiveness and cost-effectiveness of interferon beta and glatiramer acetate in the UK Multiple Sclerosis Risk Sharing Scheme at 6 years: a clinical cohort study with natural history comparator.

Findings from this large observational study of treatment with interferon beta or glatiramer acetate provide evidence that their effects on disability in patients with relapsing-remitting multiple sclerosis are maintained and cost effective over 6 years.

Therapy-related acute leukaemia with mitoxantrone: four years on, what is the risk and can it be limited?

MS treatment regimens which limit the mitoxantrone dose to < 60 mg/m(2) reduce the risk of therapy-related acute leukaemia (TRAL).

UK multiple sclerosis risk-sharing scheme: a new natural history dataset and an improved Markov model.

A new untreated MS cohort from British Columbia has been selected and will be modelled using a continuous Markov model with onset age as a baseline covariate. This approach will now be applied to the treated UK RSS MS cohort for future price adjustment calculations.

Role of intravenous immunoglobulin in the treatment of acute relapses of neuromyelitis optica: experience in 10 patients.

Prompt treatment of neuromyelitis optica (NMO) relapses with steroids or plasma exchange (PLEX) often prevents irreversible disability.

The epidemiology of neuromyelitis optica amongst adults in the Merseyside county of United Kingdom.

NMO still remains an uncommon condition, but the prevalence is rising with early diagnosis.

Neuropathic pruritus (itch) in neuromyelitis optica.

Neuropathic pruritus seems to be a common, but under-recognised symptom of myelitis associated with NMO.

The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis.

It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised.

Prognostic factors and disease course in aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder from the United Kingdom and Japan.

Neuromyelitis optica and neuromyelitis optica spectrum disorders have been recently associated with the disease-specific autoantibody aquaporin-4, thought to be pathogenic. Identifying this antibody has allowed the clinical phenotype to be broadened. Age at disease onset and genetic factors are both likely to be important in determining clinical outcomes in aquaporin-4 disease.

Fasciculations and cramps: how benign? Report of four cases progressing to ALS.

We propose that a diagnosis of benign cramps and fasciculations should not be considered secure without a minimum follow up of 4-5 years.

Immunosuppression followed by immunomodulation.

The effectiveness of such induction regimens should encourage physicians to reconsider thresholds to define treatment failure on 'first-line' therapies, the criteria for acceptable disease control, as well as the relative place of induction and escalation treatment strategies in the management of RRMS.