RESUMO
In natalizumab-treated patients without previous immunosuppressive treatment, the JCV antibody index is used to stratify PML risk. A high index value indicates that the risk to develop PML is significantly elevated, although probably about 99% of patients with this index value will not develop PML. This minireview aimed to provide an overview of the basic virology and immunology relevant to understanding JCV infections in MS patients, with a focus on what is presently known about antibodies to JCV and how they could be of use to predict and diagnose PML.
Assuntos
Anticorpos Antivirais/sangue , Fatores Imunológicos/efeitos adversos , Vírus JC/imunologia , Leucoencefalopatia Multifocal Progressiva/imunologia , Esclerose Múltipla/tratamento farmacológico , Natalizumab/efeitos adversos , Infecções por Polyomavirus , Infecções Tumorais por Vírus , Imunidade Adaptativa/fisiologia , Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Humanos , Fatores Imunológicos/uso terapêutico , Imunossupressores/efeitos adversos , Leucoencefalopatia Multifocal Progressiva/virologia , Esclerose Múltipla/complicações , Natalizumab/uso terapêutico , Infecções por Polyomavirus/imunologia , Infecções por Polyomavirus/virologia , Infecções Tumorais por Vírus/imunologia , Infecções Tumorais por Vírus/virologiaAssuntos
Transtornos de Enxaqueca/complicações , Oftalmoplegia/complicações , Adulto , Humanos , Imunoglobulina G/líquido cefalorraquidiano , Inflamação/patologia , Linfócitos/imunologia , Imageamento por Ressonância Magnética , Masculino , Transtornos de Enxaqueca/fisiopatologia , Doenças do Nervo Oculomotor/imunologia , Doenças do Nervo Oculomotor/patologia , Oftalmoplegia/fisiopatologia , Doenças do Nervo Troclear/imunologia , Doenças do Nervo Troclear/patologiaRESUMO
The aim of the study was to distinguish Benign Focal Epilepsy of Childhood with Occipital Paroxysms (BEOP) from its symptomatic counterpart on the basis of the location of the sources of the interictal EEG spikes. Patients were classified into two groups: idiopathic BEOP and symptomatic occipital lobe epilepsy. Source analysis of the averaged occipital spikes was performed using a homogeneously conducting sphere as the volume conductor model. Results showed a statistically significant difference in the eccentricity, i.e., the distance of the occipital spike focus from the centre of the head. The dipole sources of the occipital spikes in the BEOP group were found to be located more superficially than in the symptomatic group, corresponding in six of the nine cases with a source position estimated to be within the cortical layer just below the skull. The eccentricity of the symptomatic occipital spikes suggests a location deeper than the cortical layer. The results were validated in two patients from the symptomatic group. In one patient the estimated deeper dipole source location corresponded with a deeper location of spike activity observed during ECoG; in the other patient's ECoG, spike activity was observed superficially but over an extended area. The discrepancy between estimated and real location may be explained by the method of dipole source analysis used. It is concluded that the finding of a superficial dipole source location of the occipital spikes provides an indication for the diagnosis BEOP (sensitivity: 67%; specificity: 74%).
