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Chapter 1 - Autoimmune CNS Emergencies

Published online by Cambridge University Press:  10 February 2021

Carlos A. Perez ,
Andrew Smith  and
Flavia Nelson
By
Andrew Smith
Carlos A. Perez
Affiliation:
University of Texas, Houston
Andrew Smith
Affiliation:
OhioHealth Riverside Methodist Hospital in Columbus, Ohio, USA
Flavia Nelson
Affiliation:
University of Minnesota, Minneapolis
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Summary

The primary role of the neurologist in the emergency department (ED) when confronted with a potential exacerbation of a neuroimmunologic condition is first, to rule out potential “mimics,” and second, to treat acute episodes of true neurologic dysfunction.

Type
Chapter
Information
Multiple Sclerosis
A Practical Manual for Hospital and Outpatient Care
 , pp. 1 - 20
Publisher: Cambridge University Press
Print publication year: 2021

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References

Abboud, H, Mente, K, Seay, M, et al. Triaging patients with multiple sclerosis in the emergency department: room for improvement. Int J MS Care. 2017;19(6):290–6.Google Scholar
Buckley, C, Kennard, C, Swash, M. Treatment of acute exacerbations of multiple sclerosis with intravenous methyl-prednisolone. J Neurol Neurosurg Psychiatry. 1982;45(2):179–80.CrossRefGoogle ScholarPubMed
Dowling, PC, Bosch, VV, Cook, SD. Possible beneficial effect of high-dose intravenous steroid therapy in acute demyelinating disease and transverse myelitis. Neurology. 1980;30(7 Pt 2):33–6.CrossRefGoogle ScholarPubMed
Abbruzzese, G, Gandolfo, C, Loeb, C. “Bolus” methylprednisolone versus ACTH in the treatment of multiple sclerosis. Ital J Neurol Sci. 1983;4(2):169–72.CrossRefGoogle ScholarPubMed
Barnes, MP, Bateman, DE, Cleland, PG, et al. Intravenous methylprednisolone for multiple sclerosis in relapse. J Neurol Neurosurg Psychiatry. 1985;48(2):157–9.Google Scholar
Thompson, AJ, Kennard, C, Swash, M, et al. Relative efficacy of intravenous methylprednisolone and ACTH in the treatment of acute relapse in MS. Neurology. 1989;39(7):969–71.Google Scholar
Miller, DM, Weinstock-Guttman, B, Bethoux, F, et al. A meta-analysis of methylprednisolone in recovery from multiple sclerosis exacerbations. Mult Scler. 2000;6(4):267–73.Google Scholar
Filippini, G, Brusaferri, F, Sibley, WA, et al. Corticosteroids or ACTH for acute exacerbations in multiple sclerosis. Cochrane Database Syst Rev. 2000(4):CD001331.Google Scholar
Sellebjerg, F, Frederiksen, JL, Nielsen, PM, Olesen, J. Double-blind, randomized, placebo-controlled study of oral, high-dose methylprednisolone in attacks of MS. Neurology. 1998;51(2):529–34.Google Scholar
La Mantia, L, Eoli, M, Milanese, C, et al. Double-blind trial of dexamethasone versus methylprednisolone in multiple sclerosis acute relapses. Eur Neurol. 1994;34(4):199–203.Google Scholar
Beck, RW, Cleary, PA, Anderson, MM Jr, et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992;326(9):581–8.Google Scholar
Bindoff, L, Lyons, PR, Newman, PK, Saunders, M. Methylprednisolone in multiple sclerosis: a comparative dose study. J Neurol Neurosurg Psychiatry. 1988;51(8):1108–9.CrossRefGoogle ScholarPubMed
Alam, SM, Kyriakides, T, Lawden, M, Newman, PK. Methylprednisolone in multiple sclerosis: a comparison of oral with intravenous therapy at equivalent high dose. J Neurol Neurosurg Psychiatry. 1993;56(11):1219–20.Google Scholar
Oliveri, RL, Valentino, P, Russo, C, et al. Randomized trial comparing two different high doses of methylprednisolone in MS: a clinical and MRI study. Neurology. 1998;50(6):1833–6.Google Scholar
Martinelli, V, Rocca, MA, Annovazzi, P, et al. A short-term randomized MRI study of high-dose oral vs intravenous methylprednisolone in MS. Neurology. 2009;73(22):1842–8.CrossRefGoogle ScholarPubMed
Le Page, E, Veillard, D, Laplaud, DA, et al. Oral versus intravenous high-dose methylprednisolone for treatment of relapses in patients with multiple sclerosis (COPOUSEP): a randomised, controlled, double-blind, non-inferiority trial. Lancet. 2015;386(9997):974–81.Google Scholar
Weinshenker, BG, O’Brien, PC, Petterson, TM, et al. A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Ann Neurol. 1999;46(6):878–86.Google Scholar
Cortese, I, Chaudhry, V, So, YT, et al. Evidence-based guideline update: plasmapheresis in neurologic disorders: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2011;76(3):294–300.Google Scholar
Dudesek, A, Zettl, UK. Intravenous immunoglobulins as therapeutic option in the treatment of multiple sclerosis. J Neurol. 2006;253(Suppl 5):V50–8.Google Scholar
Gettig, J, Cummings, JP, Matuszewski, K. H.p. Acthar gel and cosyntropin review: clinical and financial implications. P & T. 2009;34(5):250–7.Google ScholarPubMed
Balcer, LJ. Clinical practice: optic neuritis. N Engl J Med. 2006;354(12):1273–80.Google Scholar
Beck, RW, Cleary, PA. Optic neuritis treatment trial: one-year follow-up results. Arch Ophthalmol. 1993;111(6):773–5.Google Scholar
Thompson, AJ, Banwell, BL, Barkhof, F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162–73.Google Scholar
Akaishi, T, Nakashima, I, Sato, DK, et al. Neuromyelitis optica spectrum disorders. Neuroimaging Clin North Am. 2017;27(2):251–65.Google Scholar
Joseph, FG, Scolding, NJ. Neurosarcoidosis: a study of 30 new cases. J Neurol Neurosurg Psychiatry. 2009;80(3):297–304.Google Scholar
Gonzalez-Gay, MA, Barros, S, Lopez-Diaz, MJ, et al. Giant cell arteritis: disease patterns of clinical presentation in a series of 240 patients. Medicine (Baltimore). 2005;84(5):269–76.Google Scholar
Petzold, A, Plant, GT. Chronic relapsing inflammatory optic neuropathy: a systematic review of 122 cases reported. J Neurol. 2014;261(1):17–26.CrossRefGoogle ScholarPubMed
Tang, WQ, Wei, SH. Primary Sjogren's syndrome related optic neuritis. Int J Ophthalmol. 2013;6(6):888–91.Google Scholar
Greco, A, Marinelli, C, Fusconi, M, et al. Clinic manifestations in granulomatosis with polyangiitis. Int J Immunopathol Pharmacol. 2016;29(2):151–9.CrossRefGoogle ScholarPubMed
Dalvi, SR, Yildirim, R, Yazici, Y. Behcet's syndrome. Drugs. 2012;72(17):2223–41.Google Scholar
Sedwick, LA, Klingele, TG, Burde, RM, Behrens, MM. Optic neuritis in inflammatory bowel disease. J Clin Neuroophthalmol. 1984;4(1):3–6.Google Scholar
Garcia-Carrasco, M, Mendoza-Pinto, C, Cervera, R. Diagnosis and classification of Susac syndrome. Autoimmun Rev. 2014;13(4–5):347–50.Google Scholar
McGlasson, S, Wiseman, S, Wardlaw, J, et al. Neurological disease in lupus: toward a personalized medicine approach. Front Immunol. 2018;9:1146.Google Scholar
Purvin, V, Sundaram, S, Kawasaki, A. Neuroretinitis: review of the literature and new observations. J Neuroophthalmol. 2011;31(1):58–68.Google Scholar
Kahloun, R, Abroug, N, Ksiaa, I, et al. Infectious optic neuropathies: a clinical update. Eye Brain. 2015;7:59–81.Google Scholar
Sharma, P, Sharma, R. Toxic optic neuropathy. Indian J Ophthalmol. 2011;59(2):137–41.Google Scholar
Chavala, SH, Kosmorsky, GS, Lee, MK, Lee, MS. Optic neuropathy in vitamin B12 deficiency. Eur J Intern Med. 2005;16(6):447–8.Google Scholar
Sawicka-Pierko, A, Obuchowska, I, Mariak, Z. Nutritional optic neuropathy. Klin Oczna. 2014;116(2):104–10.Google Scholar
Meyerson, C, Van Stavern, G, McClelland, C. Leber hereditary optic neuropathy: current perspectives. Clin Ophthalmol. 2015;9:1165–76.Google Scholar
Klein, NP, Ray, P, Carpenter, D, et al. Rates of autoimmune diseases in Kaiser Permanente for use in vaccine adverse event safety studies. Vaccine. 2010;28(4):1062–8.Google Scholar
Sofat, N, Malik, O, Higgens, CS. Neurological involvement in patients with rheumatic disease. QJM. 2006;99(2):69–79.Google Scholar
Torabi, AM, Patel, RK, Wolfe, GI, et al. Transverse myelitis in systemic sclerosis. Arch Neurol. 2004;61(1):126–8.Google Scholar
Frohman, EM, Kramer, PD, Dewey, RB, et al. Benign paroxysmal positioning vertigo in multiple sclerosis: diagnosis, pathophysiology and therapeutic techniques. Mult Scler. 2003;9(3):250–5.Google Scholar
Anagnostou, E, Mandellos, D, Limbitaki, G, et al. Positional nystagmus and vertigo due to a solitary brachium conjunctivum plaque. J Neurol Neurosurg Psychiatry. 2006;77(6):790–2.CrossRefGoogle ScholarPubMed
Di Stefano, G, Maarbjerg, S, Nurmikko, T, et al. Triggering trigeminal neuralgia. Cephalalgia. 2018;38(6):1049–56.CrossRefGoogle ScholarPubMed
Vakharia, K, Kamal, H, Atwal, GS, Budny, JL. Transtentorial herniation from tumefactive multiple sclerosis mimicking primary brain tumor. Surg Neurol Int. 2018;9:208.Google Scholar
Yacoub, HA, Al-Qudahl, ZA, Lee, HJ, et al. Tumefactive multiple sclerosis presenting as acute ischemic stroke. J Vasc Interv Neurol. 2011;4(2):21–3.Google Scholar
Idris, AA, Begum, T, Verlage, KR, Ahmed, M. Tumefactive multiple sclerosis presenting with tonic–clonic seizure. BMJ Case Rep. 2016;2016.Google Scholar
Weinshenker, BG. Plasma exchange for severe attacks of inflammatory demyelinating diseases of the central nervous system. J Clin Apher. 2001;16(1):39–42.Google Scholar
Algahtani, H, Shirah, B, Alassiri, A. Tumefactive demyelinating lesions: a comprehensive review. Mult Scler Relat Disord. 2017;14:72–9.Google Scholar
Johnson, MD, Lavin, P, Whetsell, WO Jr. Fulminant monophasic multiple sclerosis, Marburg's type. J Neurol Neurosurg Psychiatry. 1990;53(10):918–21.Google Scholar
Rahmlow, MR, Kantarci, O. Fulminant demyelinating diseases. Neurohospitalist. 2013;3(2):81–91.Google Scholar
Letournel, F, Cassereau, J, Scherer-Gagou, C, et al. An autopsy case of acute multiple sclerosis (Marburg's type) during pregnancy. Clin Neurol Neurosurg. 2008;110(5):514–7.Google Scholar
Kuperan, S, Ostrow, P, Landi, MK, Bakshi, R. Acute hemorrhagic leukoencephalitis vs ADEM: FLAIR MRI and neuropathology findings. Neurology. 2003;60(4):721–2.Google Scholar
Hart, MN, Earle, KM. Haemorrhagic and perivenous encephalitis: a clinical–pathological review of 38 cases. J Neurol Neurosurg Psychiatry. 1975;38(6):585–91.Google Scholar

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