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|2.||Association of Trigeminal Neuralgia with Multiple Sclerosis: A Comprehensive Review of Neuropathic Pain Treatment|
Chrysoula Petrou, Anestakis Doxakis, Marissa A. Barrera, Polyanthi Konstantinidou
doi: 10.4274/jmsr.galenos.2023.2023-1-1 Pages 1 - 8
This comprehensive review aimed to evaluate the association between trigeminal neuralgia and multiple sclerosis (MS). Neuropathic pain was analyzed, and trigeminal neuralgia and MS were compared. Pharmacological and surgical treatments for trigeminal neuralgia in patients with MS were explored in detail. The inclusion criteria were as follows: (1) studies of (2) adult participants with trigeminal neuralgia caused by MS, (3) employing pharmacological or surgical interventions and (4) evaluating outcomes related to pain reduction. Carbamazepine or oxcarbazepine is the first-line drug, and lamotrigine, baclofen, gabapentin, and pregabalin are second-line drugs. If the drug cannot control the pain, surgical options must be considered. The surgical procedures include surgical removal of peripheral lesions that are distal to the ganglion, percutaneous gasserian ganglion surgery, stereotactic radiosurgery, and microvascular decompression in the posterior fossa. Owing to the scarcity of data, medical treatment of a patient with MS-related trigeminal neuralgia is challenging. Initiating pharmacological therapy, followed by surgery, is recommended.
|3.||Real-world Results of Ocrelizumab in the Treatment of Multiple Sclerosis: A Gulf Region Single-center Experience|
Ali Hassan, Heba Elhasin, Noha Soliman, Miklos Szolics
doi: 10.4274/jmsr.galenos.2023.2022-12-2 Pages 9 - 13
INTRODUCTION: This study aimed to describe the real-world effectiveness and tolerability of ocrelizumab treatment at MS Clinic, Tawam Hospital.
METHODS: This retrospective, observational, single-center study analyzed the medical records of patients with multiple sclerosis (MS) receiving the standard dose of ocrelizumab.
RESULTS: After starting ocrelizumab, 3 of the 19 patients included in the study experienced disease progression, 3 showed disability improvement,
and the remaining 13 had stable status. None of the 15 patients with relapsing-remitting MS experienced a relapse. The average expanded disability status scale of all patients dropped from 2.32 to 2.22, when switched to ocrelizumab. After the follow-up period, 16 (84.21%) patients did not have any magnetic resonance imaging activity.
DISCUSSION AND CONCLUSION: As an MS treatment, ocrelizumab is associated with a favorable response in terms of both efficacy and safety in clinical practice
settings. The efficacy and safety demonstrated must be further evaluated to provide real-world evidence for the use of ocrelizumab.
|4.||Demographic and Clinical Characteristics of Persons with Multiple Sclerosis with Psychiatric Disorders|
Ozge Sagici, Hilal Karakas, Ergi Kaya
doi: 10.4274/jmsr.galenos.2023.2022-12-1 Pages 14 - 17
INTRODUCTION: Psychiatric syndromes (PS) are among the most common comorbidities seen in multiple sclerosis (MS). It has been demonstrated that
PS, such as depression, anxiety, and bipolar disorder, are more common in people with MS (pwMS) than in the general population. However, the reasons for this remain unknown. We aimed to identify the demographic and clinical characteristics of pwMS with PS and compare them with pwMS without PS.
METHODS: In total, 2,732 (1,886 female; 846 male) pwMS attending the outpatient MS Clinic of Dokuz Eylul University Hospital were included in the study. We recorded the age, gender, disease duration, duration of PS diagnosis, age of onset, and MS course of the pwMS.
RESULTS: PS had been diagnosed in 383 (14%) of pwMS, and in 352 of those it were diagnosed after their MS. There was no significant difference between the two groups in terms of disease duration and duration of diagnosis. There were significant differences regarding age, gender, age of onset, and MS classification between the two groups. The age and age of onset of PS in pwMS (45.89±11.50 and 30.42±9.81, respectively) were higher than in pwMS without a PS (44.09±12.57 and 29.29±9.74, respectively). The rate of female pwMS with a PS (76.4%) was higher than female pwMS without a PS (67.8%). Regarding the MS type, whereas 81% of those who had PS had relapsing-remitting MS (RRMS), 15.6% had secondary progressive MS (SPMS), and 3.4% had primary progressive MS (PPMS). Furthermore, 85.4% of those who had no PS were RRMS, 11% were SPMS, and 3.6% were PPMS.
DISCUSSION AND CONCLUSION: In this study, the most related factors were age, gender, age of onset, and MS course for PS in MS. Studies involving other clinical
features and cognitive functions are needed to better understand PS in MS.
|5.||The Relationship Between the Styles of Coping with Stress of Multiple Sclerosis Patients and the Perception of Social Support|
Yılmaz Inanc, Tugba Kaya
doi: 10.4274/jmsr.galenos.2023.2022-12-3 Pages 18 - 23
INTRODUCTION: This study examined the effect of perceived social support on the coping styles of patients with multiple sclerosis (pwMS) and their
relationship with disability.
METHODS: In total, 100 pwMS who applied to the Neurology Outpatient Clinic of Kahramanmaras Sutcu Imam University Medical Faculty Hospital and 100 healthy controls were included in the study. Disease duration, MS type, and Expanded Disability Status Scale (EDSS) scores for pwMS were evaluated. The socio-demographic information form, multidimensional scale of perceived social support, scale for coping with stress, and Beck depression inventory were used.
RESULTS: The family, friend, and special person subdimensions of the perceived social support mechanism among pwMS and the helpless, optimistic, submissive, and self-confident approaches from the stress-coping subdimensions were positively correlated. However, the social support-seeking factor subdimension was negatively correlated. In the analysis of the effect of the social support level and coping mechanisms on each other in pwMS, a positive and significant correlation was found between the family and special person subdimensions and the optimistic approach. Moreover, pwMS had a mean score of 19.6±6.1 in the family subdimension of the perceived social support scale, 16.8±7.6 in the friend subdimension, and 19.5±6.1 in the special person subdimension. The helpless, submissive approach, and social support-seeking scores were 2.4±0.6, 2.4±0.6, and 3.1±0.5, respectively. In the analysis of the average of the scores obtained from the depression inventory, pwMS had an average score of 22±14, and the control group had an average score of 14.1±10.8. The mean scores of the pwMS in the helpless approach (p<0.05), submissive approach (p<0.05), and depression (p<0.05) inventory were significantly higher than those in the control group (p>0.05). The mean scores of the helpless approach (p<0.05) and the submissive approach (p<0.05) of pwMS with an EDSS score of >3 were significantly higher than those of pwMS with an EDSS score of ≤3.
DISCUSSION AND CONCLUSION: Coping strategies change throughout the disease. Specifically, patients with moderate-to-severe disabilities will need help coping with their existing disorder. As disability increases, the social support provided by family, friends, or spouses becomes more important.