Multiple Sclerosis: Gilhus NE

Elovaara I, Apostolski S, van Doorn P, Gilhus NE, Hietaharju A, Honkaniemi J, van Schaik IN, Scolding N, Soelberg Sørensen P, Udd B, Anonymous00010. · Department of Neurology and Rehabilitation, Tampere University Hospital and Medical School, University of Tampere, Tampere, Finland. · Eur J Neurol. · Pubmed #18796075 No free full text.

Abstract: Despite high-dose intravenous immunoglobulin (IVIG) is widely used in treatment of a number of immune-mediated neurological diseases, the consensus on its optimal use is insufficient. To define the evidence-based optimal use of IVIG in neurology, the recent papers of high relevance were reviewed and consensus recommendations are given according to EFNS guidance regulations. The efficacy of IVIG has been proven in Guillain-Barré syndrome (level A), chronic inflammatory demyelinating polyradiculoneuropathy (level A), multifocal mononeuropathy (level A), acute exacerbations of myasthenia gravis (MG) and short-term treatment of severe MG (level A recommendation), and some paraneoplastic neuropathies (level B). IVIG is recommended as a second-line treatment in combination with prednisone in dermatomyositis (level B) and treatment option in polymyositis (level C). IVIG should be considered as a second or third-line therapy in relapsing-remitting multiple sclerosis, if conventional immunomodulatory therapies are not tolerated (level B), and in relapses during pregnancy or post-partum period (good clinical practice point). IVIG seems to have a favourable effect also in paraneoplastic neurological diseases (good practice point) [corrected],stiff-person syndrome (level A), some acute-demyelinating diseases and childhood refractory epilepsy (good practice point).

Barnes MP, Gilhus NE, Wender M, Anonymous00025. · University of Newcastle upon Tyne, Hunters Moor Regional Neurorehabilitation Centre, Hunters Road, Newcastle upon Tyne, UK. · Eur J Neurol. · Pubmed #11328328 No free full text.

This publication has no abstract.

Gjerstad L, Gilhus NE, Storstein A. · Department of Neurology, Division of Clinical Neuroscience, Rikshospitalet University Hospital, Oslo, Norway, and University of Oslo, Oslo, Norway. · Acta Neurol Scand Suppl. · Pubmed #18439214 No free full text.

Abstract: This brief historical review on neuroscience in Norway shows a comparatively high research activity with many important results. The Norwegian zoologist Fridtjof Nansen, who later became a famous Arctic explorer, was the first to formulate the neuron doctrine. 'The Oslo School of Neuroanatomy' contributed enormously to the understanding of the detailed anatomy and chemistry of the central nervous system. Norwegian neurophysiologists made important findings from studies of hippocampus including the inhibitory basket cell, the LTP phenomenon and the 'hippocampal-slice-technique'. In clinical neuroscience the description of Refsum's disease and studies of myasthenia gravis and multiple sclerosis have been of particular importance. Two of 13 centres of excellence in Norway selected in 2003 were from neuroscience, and The Norwegian Research Council has its own programme for neuroscience. The Norwegian Neurological Association arranges annual meetings to promote interest in neurological research.

Dahl J, Myhr KM, Daltveit AK, Gilhus NE. · Dept. of Clinical Medicine, University of Bergen, Bergen, Norway. · J Neurol. · Pubmed #18283397 No free full text.

Abstract: To investigate the influence of maternal multiple sclerosis (MS) on pregnancy, we compared pregnancy, delivery and birth outcome in births prior to onset of MS (pre MS), between MS onset and diagnosis (early MS), and after diagnosis of MS (manifest MS). Mothers with MS were identified through linkage of the Norwegian MS Registry and the Medical Birth Registry of Norway (1967-2002). All pre MS births (n = 1910), early MS births (n = 555), and manifest MS births (n = 308) were compared.There was a significantly lower mean birth weight in term births (adjusted for gestation in weeks, mother's age, time period and caesarean section) in the manifest MS compared to the pre MS group (P = 0.046). The rate of birth complications and interventions did not differ between the three groups.Manifest MS in birth-giving mothers seems to affect birth weight.

Dahl J, Myhr KM, Daltveit AK, Skjaerven R, Gilhus NE. · Section of Neurology, Department of Clinical Medicine, University of Bergen, Bergen, Norway. · Eur J Neurol. · Pubmed #17880567 No free full text.

Abstract: Multiple sclerosis (MS) in women leads to increased risk of operative delivery and reduced birth weight, which are presumably related to the neurological dysfunction in this patient group. Lifestyle factors may also contribute, and we therefore investigated smoking habits and relevant social factors in pregnant MS women. In total, 372,128 births were registered in the compulsory Medical Birth Registry of Norway from December 1, 1998 to October 6, 2005, and of them 250 by MS mothers. The MS births were compared with all the non-MS births. Smoking during pregnancy was not increased in the MS group compared with the non-MS references. From 1998 to 2005 the MS group had a larger reduction in smoking rate during pregnancy than the reference group. The differences in pregnancy and birth outcome between smokers and non-smokers were similar in the MS and the reference group. Those in the smoking MS group had no increase in birth complications, operative interventions or negative birth outcome compared with those in the smoking reference group. Smoking during pregnancy did not explain the birth weight reduction found for newborns of MS mothers.

Dahl J, Myhr KM, Daltveit AK, Gilhus NE. · Department of Clinical Medicine, Section of Neurology, University of Bergen and Department of Neurology, Haukeland University Hospital, Norway. · Acta Neurol Scand Suppl. · Pubmed #16637930 No free full text.

Abstract: OBJECTIVE: The objective of this study was to investigate the effect of maternal multiple sclerosis (MS) on delivery and birth outcome in births without planned caesarean section. METHODS: Data were collected from the compulsory Medical Birth Registry of Norway from 1988 to 2002. Intended vaginal births in this time period were 449 births given by MS mothers and 851,060 control births. RESULTS: The MS mothers had a higher rate of induction of labour, and there was a strong trend for slower progression of second stage of labour and increased use of forceps. The MS group had lower birth weight and length of the neonates. The frequency of birth defects and the neonatal mortality were not increased in the MS group. CONCLUSIONS: Maternal MS affects the birth process and the neonate prenatally, even when the births with planned caesarean section are excluded. MS-related neuronal dysfunction linked to the uterus, is postulated as the most likely mechanism.

Dahl J, Myhr KM, Daltveit AK, Hoff JM, Gilhus NE. · Department of Clinical Medicine, University of Bergen, Norway. · Neurology. · Pubmed #16380620 No free full text.

Abstract: Using data from the compulsory Medical Birth Registry of Norway, the authors investigated the effect of maternal multiple sclerosis (MS) on pregnancy, delivery, and birth outcome in 649 births by MS mothers and 2.1 million control births. The mothers with MS had a higher proportion of neonates small for gestational age and also more frequent induction and operative interventions during delivery.