Subject(s)
Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal/immunology , Hypersensitivity, Delayed/chemically induced , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Antibodies/immunology , Antibodies, Monoclonal, Humanized , Humans , Hypersensitivity, Delayed/immunology , Hypersensitivity, Delayed/pathology , Male , Middle Aged , Multiple Sclerosis, Relapsing-Remitting/immunology , Natalizumab , Serum Sickness/chemically induced , Serum Sickness/immunology , Serum Sickness/pathologyABSTRACT
AIM: To describe associations of abnormalities in the electroencephalogram (EEG) with the most prevalent diagnoses in a memory clinic cohort. METHODS: Associations between visual EEG findings and diagnoses in 1,116 consecutive patients [382 Alzheimer's disease (AD), 274 subjective complaints, 190 mild cognitive impairment (MCI), 118 psychiatric disorder, 61 frontotemporal lobar degeneration, 53 vascular dementia (VaD), 38 dementia with Lewy bodies (DLB)] were determined by prevalence ratio (PR). RESULTS: Diagnoses of subjective complaints [PR = 1.6; 95% confidence interval (CI) = 1.4-1.9] and psychiatric disorder (1.4; 95% CI = 1.1-1.9) were associated with a normal EEG, while subjects with both focal and diffuse EEG disturbances were more likely to have DLB (3.5; 95% CI = 2.1-5.6), VaD (2.3; 95% CI = 1.4-3.6) or AD (1.5; 95% CI = 1.3-1.8). Subjects with only diffuse EEG abnormalities were more likely to have AD (PR = 1.5; 95% CI = 1.3-1.9). The prevalence of MCI was higher among those with only focal EEG abnormalities (PR = 1.3; 95% CI = 1.0-1.7). CONCLUSIONS: A normal EEG argues for subjective complaints or psychiatric diagnosis. An EEG with only focal abnormalities supports MCI. An EEG with only diffuse abnormalities argues for AD. An EEG with both focal and diffuse abnormalities argues for DLB, VaD or AD.
Subject(s)
Electroencephalography , Memory Disorders/diagnosis , Memory Disorders/physiopathology , Aged , Alzheimer Disease/diagnosis , Alzheimer Disease/physiopathology , Cohort Studies , Dementia/diagnosis , Dementia/physiopathology , Female , Humans , Male , Middle AgedABSTRACT
Sulphasalazine, one of the 5-amino-salicylates, is widely used for the treatment of inflammatory bowel diseases and arthritis. Among the reported adverse effects are blood dyscrasias and hepatic failure. Peripheral neuropathy has been reported as a rare adverse drug reaction to sulphasalazine. Most reported patients developed symptoms several weeks after onset of treatment. We describe a patient with an axonal polyneuropathy that occurred after two years of treatment with sulphasalazine.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Neurotoxicity Syndromes/etiology , Polyneuropathies/chemically induced , Sulfasalazine/adverse effects , Adult , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Drug Administration Schedule , Female , Humans , Spondylarthropathies/drug therapy , Sulfasalazine/administration & dosage , Young AdultABSTRACT
OBJECTIVE: To determine whether patients with definite multiple sclerosis (MS) and repeated positive anticardiolipin antibody (aCL Ab) testing fulfil the recently updated criteria for the antiphospholipid syndrome (APS). Also, to determine if these patients form a separate subgroup in terms of long term follow-up and MRI characteristics. DESIGN: A blinded case control study comparing MRI patterns between aCL Ab positive and negative MS patients with a clinical follow-up of 7 years. PARTICIPANTS: 8 (5.6%; male:female ratio 2:6; 6 relapsing-remitting subtype, 1 primary progressive subtype and 1 neuromyelitis optica (NMO)) of 143 consecutive patients with definite MS or NMO (71% relapsing-remitting, 18% secondary progressive and 6% primary progressive disease course; 4% NMO) showed repeated positive aCL Ab testing. SETTING: Outpatient clinic of a tertiary MS centre in The Netherlands. RESULTS: All eight aCL Ab positive patients had levels below 40 MPL/GPL units, with the majority of intervals between tests of at least 12 weeks. After follow-up, none of the patients fulfilled the criteria for APS. No specific MRI features were present compared with 24 matched aCL Ab negative patients. CONCLUSIONS: No aCL Ab positive MS patient fulfilled the criteria for APS, arguing against a possible misdiagnosis or coexistence.
