Guillain-Barré syndrome after orthotopic liver transplantation: A clinical manifestation of immune reconstitution inflammatory syndrome?

Guillain-Barrè Syndrome, as part of the spectrum of dysimmune neuropathies, is unexpected to occur in immunocompromised hosts. We describe a clinical case of Guillain-Barrè syndrome, occurred a few weeks after a liver transplant, and we postulate that our case would satisfy all requirements to explain this peripheral nervous system complication as a clinical manifestation of an Immune reconstitution inflammatory syndrome. In this setting of liver transplantation, complicated by potentially multiple infective triggers, reduction of immunosuppression and reversal of pathogen-induced immunosuppression, through antimicrobial therapy, may have led to pro-inflammatory response. The pro-inflammato…

Crossed aphasia in a dextral without impairment of visuo-spatial abilities: a case report

Clinical features and disease out come in patients with pediatric and young adult onset Multiple Sclerosis

PREGNANCIES MODIFY RELAPSES AND PROGRESSION IN MULTIPLE SCLEROSIS

Genetic burden in multiple sclerosis families

A previous study using cumulative genetic risk estimations in multiple sclerosis (MS) successfully tracked the aggregation of susceptibility variants in multi-case and single-case families. It used a limited description of susceptibility loci available at the time (17 loci). Even though the full roster of MS risk genes remains unavailable, we estimated the genetic burden in MS families and assess its disease predictive power using up to 64 single-nucleotide polymorphism (SNP) markers according to the most recent literature. A total of 708 controls, 3251 MS patients and their relatives, as well as 117 twin pairs were genotyped. We validated the increased aggregation of genetic burden in mult…

Primary Progressive and progressive relapsing multiple sclerosis show different clinical and instrumental findings and disability progression? A comparison study on a Sicilian database

Natalizumab therapy of relapsing-remitting multiple sclerosis: an evaluation of the safety profile and a comparison of efficacy with interferon beta therapy

Clinical features, disease course and prognosis in patients with paediatric and young adult onset multiple sclerosis

Background. Multiple sclerosis (MS) patients develop their first symptoms before adolescence approximately in 5%. Studies comparing clinical and prognostic characteristics in early onset MS, did not show homogeneous results. Objective. Aim of this study was to investigate characteristics of early onset MS patients and compare them with patients who experienced MS onset later. Methods. MS patients diagnosed as affected by MS according to Poser's criteria, were included if they experienced symptoms onset before age 25. They were classified in three groups. Group A: patients who had their onset until they were 16 years old Group B: individuals with onset between 17 and 20 yearsGroup C: patient…

Assessment of cerebral microbleeds by susceptibility-weighted imaging at 3T in patients with end-stage organ failure

Purpose: Cerebral microbleeds (CMBs) are small rounded lesions representing cerebral hemosiderin deposits surrounded by macrophages that results from previous microhemorrhages. The aim of this study was to review the distribution of cerebral microbleeds in patients with end-stage organ failure and their association with specific end-stage organ failure risk factors. Materials and methods: Between August 2015 and June 2017, we evaluated 15 patients, 9 males, and 6 females, (mean age 65.5 years). Patients population was subdivided into three groups according to the organ failure: (a) chronic kidney failure (n = 8), (b) restrictive cardiomyopathy undergoing heart transplantation (n = 1), and (…

Lifestyle factors and multiple sclerosis: a case control study

Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience.

Background: Cerebral small vessels disease (cSVD) is an age-related disorder and risk factor for stroke and cognitive/motor impairments. Neurological complications (NCs) are among the causes of adverse outcomes in older liver transplant recipients. This study sought to determine whether cSVD predicts acute NCs in over 65-year-old liver transplant patients. Methods: Data were collected, from a retrospective medical chart review, of 22 deceased donor liver transplant recipients aged 65 years or older with a pre-operative brain magnetic resonance imaging (MRI). We used the Fazekas score (0–3) as a quantitative measurement of the vascular lesion load seen in the MRI. We analyzed all post-operat…

IMMUNOSUPPRESSANT TREATMENT AND CANCER RISK IN A COHORT OF PATIENTS AFFECTED BY MULTIPLE SCLEROSIS

Association between multiple sclerosis, cancer risk, and immunosuppressant treatment: a cohort study

Abstract Background The association between multiple sclerosis (MS) and cancer has long been investigated with conflicting results. Several reports suggest an increased cancer risk among MS patients treated with immunosuppressant (IS) drugs. Methods We performed a cohort study including MS patients recruited at the Neurological Department of the University of Palermo. Mean follow-up period was ten years for the whole cohort. We calculated cancer incidence among patients treated with IS. Incidence rates were compared in the cohort by calculating the relative risk according to length and dose of exposure to IS. Cancer incidence among MS patients was compared to cancer incidence in the general…

Clinical and instrumental predictors of efficacy of natalizumab therapy in the course of multiple sclerosis: a retrospective study from a single centre

Brain-core temperature of patients before and after orthotopic liver transplantation assessed by DWI thermometry

To assess brain-core temperature of end-stage liver disease patients undergoing orthotopic liver transplantation (OLT) using a temperature measurement technique based on the apparent diffusion coefficient of the cerebrospinal fluid in the lateral ventricles. The study group was composed of 19 patients with a model for end-stage liver disease (MELD) score of 23.7 who underwent MR imaging before and after OLT. MR imaging studies were performed with a 1.5T MR scanner. Brain-core temperature (T: °C) was calculated using the following equation from the apparent diffusion coefficient (D) of the cerebrospinal fluid in the lateral ventricles: $$T = {{2256.74} \mathord{\left/ {\vphantom {{2256.74} {…

Resting-State Functional Connectome in Patients with Brain Tumors Before and After Surgical Resection

Purpose: High-grade glioma surgery has evolved around the principal belief that a safe maximal tumor resection improves symptoms, quality of life, and survival. Mapping brain function has been recently improved by resting-state functional magnetic resonance imaging (rest-fMRI), a novel imaging technique that explores networks connectivity at “rest.” Methods: This prospective study analyzed 10 patients with high-grade glioma in whom rest-fMRI connectivity was assessed both in single-subject and in group analysis before and after surgery. Seed-based functional connectivity analysis was performed with CONN toolbox. Network identification focused on 8 major functional connectivity networks. A v…

Multiple reversibile MR signals in course of Epstein-Barr virus encephalitis

Dentatorubral-pallidoluysian atrophy: haplotype of Asian origin in 2 Italian families.

IDENTIFICATION OF A NOVEL COMPOUND HETEROZYGOUS MUTATION OF SPG11 IN A PATIENT AFFECTED BY HSPWITH THIN CORPUS CALLOSUM

Return of disease activity after natalizumab therapy discontinuation in patients with multiple sclerosis: frequency and clinical and instrumental predictors of reactivation

DENTATO-RUBRAL PALLIDOLUYSIAN ATROPHY: CLINICAL AND GENETIC ANALYSIS OF A SICILIAN PEDIGREE

Extracellular vesicles isolated by cerebrospinal fluid as biomarkers of inflammation in multiple sclerosis and inflammatory neurological diseases.

Resting-State Functional Magnetic Resonance Imaging for Brain Tumor Surgical Planning: Feasibility in Clinical Setting.

The aim of this study was to introduce resting-state functional magnetic resonance imaging (rest-fMRI) capability for brain tumor surgical planning. rest-fMRI is an emerging functional neuroimaging technique potentially able to provide new insights into brain physiology and to provide useful information regarding brain tumors in preoperative and postoperative settings. rest-fMRI evaluates low-frequency fluctuations in the blood oxygen level–dependent signal while the subject is at rest during magnetic resonance imaging examination. Multiple resting-state networks have been identified, including the somatosensory, language, and visual networks, which are of primary importance for surgical pl…

Thyroid autoimmunity and dysfunction in multiple sclerosis patients during long-term treatment with interferon beta or glatiramer acetate: an Italian multicenter study.

Few long-term follow-up data are available on thyroid dysfunction (TD) in multiple sclerosis (MS) patients treated with glatiramer acetate (GA) or with interferon-beta (IFNb). In a cohort of 787 relapsing-remitting MS (RRMS) patients whom were followed up for 8 years, we observed an increased prevalence of TD and thyroid autoimmunity (TA) within the first year of IFNb treatment, regardless of the dose or frequency of administration, while no change was observed with GA treatment. The increased prevalence of TD and TA within the first year of IFNb treatment suggested the need for close monitoring of thyroid function and autoimmunity, though only during the first year of IFNb treatment. © Th…

LEPROSY: A CASE REPORT FROM SICILY, ITALY

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Clinical and Instrumental Findings and Disability Progression in Primary Progressive and Progressive Relapsing Multiple Sclerosis: A Comparison Study of a Sicilian Group of Patients

Purine metabolism and multiple sclerosis: pattern varies according to disease stage and clinical form

Clinical and instrumental predictors of efficacy of Natalizumab therapy in multiple sclerosis patients: a retrospective study from a single centre

Brain magnetic resonance imaging radiomics features associated with hepatic encephalopathy in adult cirrhotic patients.

Abstract Purpose Hepatic encephalopathy (HE) is a potential complication of cirrhosis. Magnetic resonance imaging (MRI) may demonstrate hyperintense T1 signal in the globi pallidi. The purpose of this study was to evaluate the performance of MRI-based radiomic features for diagnosing and grading chronic HE in adult patients affected by cirrhosis. Methods Adult patients with and without cirrhosis underwent brain MRI with identical imaging protocol on a 3T scanner. Patients without history of chronic liver disease were the control population. HE grading was based on underlying liver disease, severity of clinical manifestation, and number of encephalopathic episodes. Texture analysis was perfo…

Advanced magnetic resonance imaging of cortical laminar necrosis in patients with stroke

Purpose The aim of this study was to assess the novel advanced magnetic resonance imaging findings of acute stage cortical laminar necrosis developing after complicated cardiovascular or abdominal surgery. Materials and methods This institutional review board-approved study included patients with postoperative stroke due to cortical laminar necrosis imaged with magnetic resonance in the acute stage. Brain magnetic resonance imaging examinations were obtained on a 3T magnetic resonance scanner within 48 hours of the neurological symptoms, including diffusion-weighted images (b value, 1000 s/mm2) and arterial spin labelling using a pseudo-continuous arterial spin labelling method in four pati…

Heart involvement in patients treated with mitoxantrone for multiple sclerosis

Frequency of John Cunningham virus (JCV) DNA and of antibodies against JCV in patients affected by multiple sclerosis and their relationship with natalizumab therapy

Purine metabolism and Multiple Sclerosis: different pattern according to different disease stage and different clinical form.

P422 Purine metabolism and multiple sclerosis: pattern varies according to disease stage and clinical form G. Salemi, M. Gueli, V. Cusimano, M. Lo Re, V. Lo Re, M.A. Mazzola, S. Realmuto, P. Ragonese, G. Savettieri University (Palermo, IT) Background: Serum concentration of uric acid (sUA) was variably associated with Multiple Sclerosis (MS). Many papers reported lower sUA in MS patients respect to healthy controls, expecially in course of relapse. This lower sUA was considered as a marker of oxidative stress. However, this association was not confirmed by many other papers. Recently, an increase in the concentration of sUA, hypoxanthine, xanthine, and sum of oxypurine (sPU) was reported in…

A CASE OF JUVENILE STROKE CAUSED BY ACTINIC CERVICAL ARTERIOPATHY

Introduction: Radiation Arteriopathy is a vascular disease characterized by progressive arterial stenosis that may occur after external radiotherapy (RT) directed to a specific body region affected by malignant tumours. The arterial damage usually starts many years after the injury and the specific pathogenesis is unknown, though atherosclerosis praecox, endothelial damage, adventitial fibrosis and vasa vasorum obliteration are likely involved mechanisms. In patients with previously irradiated neck or head cancers, supra aortic arteries can be affected in their segments exposed to radiations leading to a gradual lumen narrowing. This late complication leads to a progressive stenosis of extr…