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Progressive multifocal leukoencephalopathy during fumarate monotherapy of psoriasis
In September 2013, a 69-year-old Caucasian man who was anti–JC virus (JCV) antibody positive was admitted to our hospital with slowly progressing right hemiparesis and aphasia lasting for approximately 6 months. Medical history revealed arterial hypertension, biological aortic valve replacement, and psoriasis vulgaris, treated with 3–6 tablets daily of dimethylfumarate (DMF; 120 mg)/ethylhydrogenfumarate (EHF; 95 mg) (Fumaderm, Biogen Idec, Ismaning, Germany) since December 2008 (table e-1 at Neurology.org/nn). No other immunosuppressive pretreatment had been given. In April/May 2013, the patient recognized a s...
Source: Neurology Neuroimmunology and Neuroinflammation - March 12, 2015 Category: Neurology Authors: Hoepner, R., Faissner, S., Klasing, A., Schneider, R., Metz, I., Bellenberg, B., Lukas, C., Altmeyer, P., Gold, R., Chan, A. Tags: Multiple sclerosis, Encephalitis, Viral infections Clinical/Scientific Notes Source Type: research

A Case Of Hemophagocytic Lymphohistiocytosis Syndrome In A Patient With Multiple Sclerosis On Fingolimod Therapy. (P2.206)
CONCLUSIONS:As far as we know, this syndrome has never been reported in fingolimod treated patients. EBV reactivation may have been the triggering factor of HLH in our patient. Whether fingolimod contributed to HLH, through a direct mechanism, or indirectly favoring EBV reactivation, remains unknown. Our case highlights the diagnostic challenge of HLH and the need of monitoring and reporting serious adverse events in patients exposed to new IMD. Study Supported by:Disclosure: Dr. Abreu has received personal compensation for activities with Bayer Pharmaceuticals Corporation, Novartis, and Biogen Idec. Dr. Peixoto has nothin...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Abreu, P., Peixoto, C., Carvalho, C., Santos, L., Sarmento, A., Jose Sa, M. Tags: MS and CNS Inflammatory Disease: Treatment Safety Source Type: research

Think outside the box, collapse the box, and take a sharp knife to it!
A 74 year–old woman presented in December 2011 with left sided cerebellar symptoms. She was initially diagnosed as having a posterior circulation infarction and discharged from hospital on appropriate medication. However, over the following month she continued to deteriorate, developing increasing unsteadiness, falls, nausea and vomiting. Following a second admission in January 2012 she had a single seizure and developed focal left sided myoclonus affecting mainly the upper limb. Over the following month the myoclonus spread to affect all four limbs, although it remained more prominent on the left side. There was evi...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Dobson, R., McMillan, A., Kung, K., Thom, M., Davis, A., Simister, R., Giovannoni, G., Gnanapavan, S. Tags: Immunology (including allergy), HIV/AIDS, Tropical medicine (infectious diseases), Brain stem / cerebellum, Epilepsy and seizures, Infection (neurology), Multiple sclerosis, Stroke, Ophthalmology, Radiology, Surgical diagnostic tests Association of Brit Source Type: research