Abstract:
:Natalizumab is a monoclonal therapeutic antibody that inhibits migration of lymphocytes into the central nervous system (CNS) by blocking integrins. Several clinical trials have shown an excellent efficacy in the treatment of relapsing remitting multiple sclerosis. This efficacy is also underlined by postmarketing data of patients with a more aggressive disease compared with the clinical trials. Certain patients might even improve during natalizumab treatment. These positive effects have to be balanced against potential adverse events. In this respect, allergic reactions, hematologic abnormalities, melanoma, lymphoma, infections, and most importantly, progressive multifocal leukoencephalopathy (PML) are discussed. A special emphasis is put on the risk stratification algorithm for PML and approaches for PML treatment. Further, patient and disease characteristics are discussed that might prompt the start or cessation of natalizumab. Finally, data on how to continue after stopping natalizumab are summarized.
journal_name
Semin Neuroljournal_title
Seminars in neurologyauthors
Derfuss T,Kuhle J,Lindberg R,Kappos Ldoi
10.1055/s-0033-1343793subject
Has Abstractpub_date
2013-02-01 00:00:00pages
26-36issue
1eissn
0271-8235issn
1098-9021journal_volume
33pub_type
杂志文章,评审abstract::Headaches are a common complaint for most women during their lifetime, including gestation and puerperium. Tension-type headaches and migraine flare-ups are the most common headache complications after delivery, but the differential diagnosis of postpartum headache is broad. The clinician must distinguish common heada...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1293537
更新日期:2011-09-01 00:00:00
abstract::Infective endocarditis (IE) is a systemic disease with many potential neurologic manifestations including ischemic and hemorrhagic strokes, cerebral microbleeding, infectious intracranial aneurysms, meningitis, brain abscesses, and encephalopathy. The majority of left-sided (heart) IE patients have brain lesions that ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1688826
更新日期:2019-08-01 00:00:00
abstract::Severe spastic tone and/or spastic hypertonia can be the most disabling consequences of a neurologic insult, resulting from an excess of muscle tone. Baclofen, a GABA-B agonist, is one of the most widely used drugs in treating abnormal or disabling spastic tone. However, the effectiveness of baclofen taken orally is o...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1396012
更新日期:2014-11-01 00:00:00
abstract::The management of severe brain injury requires a comprehensive approach in which imaging is an indispensable complement to the clinical and physiological information acquired at the bedside. Neuroimaging methods are routinely used in the diagnosis and prognosis of a broad spectrum of patients with acute neurological d...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1105977
更新日期:2008-11-01 00:00:00
abstract::Neuroimaging is commonly utilized in the evaluation of post-cardiac arrest patients, providing a unique ability to visualize and quantify structural brain injury that can complement clinical and electrophysiologic data. Despite its lack of validation, we would advocate that neuroimaging is a valuable prognostication t...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1594253
更新日期:2017-02-01 00:00:00
abstract::The optic nerve is our most important cranial nerve. As it courses from the eyeball to the brain, it is divided into four segments: intraocular, intraorbital, intracanalicular, and intracranial. Four tests are primarily used to assess its functional integrity and detect optic nerve disorders. These tests are described...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1124020
更新日期:2009-02-01 00:00:00
abstract::The management of epilepsy in women encompasses a complex interplay between seizures, sex steroid hormones, and antiepileptic drugs (AEDs). These interactions impact every aspect of the sexual and reproductive health of women with epilepsy throughout their lifetimes. Neurologists comfortable treating seizures may feel...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-985335
更新日期:2007-09-01 00:00:00
abstract::Parkinsonism is a clinical syndrome, which is characterized by bradykinesia, rigidity, rest tremor, and postural instability. Idiopathic Parkinson disease (PD) is the most common cause of this syndrome, though there are several other important etiologies that must be considered. These include the atypical Parkinsonian...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1585097
更新日期:2016-08-01 00:00:00
abstract::Both general neurologists and neurologists with a broad spectrum of subspecialty interests are often asked to evaluate patients with disorders of the spinal cord. Over the past decade, there have been significant advances in our understanding of a wide spectrum of immune-mediated, infectious, metabolic, hereditary, pa...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0029-1244993
更新日期:2010-02-01 00:00:00
abstract::Leptomeningeal metastasis occurs in ~5% of all patients with cancer and is the third most common metastatic complication of the central nervous system. Staging of leptomeningeal metastasis includes contrast-enhanced brain and spine magnetic resonance imaging and radionuclide cerebrospinal fluid (CSF) flow study. Treat...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0030-1255220
更新日期:2010-07-01 00:00:00
abstract::Myelopathy refers to a spinal cord disorder that presents with motor and/or sensory deficits. Infectious agents that cause myelopathy do so by either direct infection of neural structures (e.g., polio), a parainfectious mechanism (with a presumed autoimmune pathogenesis), or as a result of involvement of structures ad...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1322588
更新日期:2012-04-01 00:00:00
abstract::Primary brain tumors are common causes of focal epilepsy, accounting for 5% of new-onset seizures in adults and over 10% of lesional focal epilepsies. These epilepsies are often refractory to medical treatment, and high rates of seizure freedom can be achieved with gross total resections. However, the management strat...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1552628
更新日期:2015-06-01 00:00:00
abstract::I argue that there is no mind-brain problem but rather that there are irreducible subjective-objective problems. These include the difference between "inside" and "outside" perspectives on neural states, the creation of subjective neural states with objectified outside objects, and awareness of the self as an object i...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040917
更新日期:1997-06-01 00:00:00
abstract::Neuropathic pain management is challenging, and typically requires a multifaceted approach. There are several treatment options, both pharmacologic and nonpharmacologic. Of the available pharmacologic agents, those with the strongest supporting evidence include tricyclic antidepressants, serotonin-norepinephrine reupt...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1673679
更新日期:2018-12-01 00:00:00
abstract::Epilepsy is one of the most common neurological conditions encountered worldwide. The development of newer antiepileptic drugs (AEDs) has expanded over recent years, and the use of such drugs for indications other than epilepsy has also broadened. These factors insure that the majority of health care providers will be...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2002-36645
更新日期:2002-09-01 00:00:00
abstract::Neurology has not typically been associated with international relief work; however, with the growth of chronic cardiovascular disease and stroke associated with unhealthy eating and sedentary ways, the appearance of "new" neurologic diseases, such as the Zika and West Nile viruses, and the high numbers of seizure dis...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1647245
更新日期:2018-04-01 00:00:00
abstract::Lightning and electrical injuries have widespread manifestations involving almost all organ systems of the body, including the central nervous system (CNS) and the eye. This article considers the neuro-ophthalmologic effects of lightning and electrical injury. ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1041041
更新日期:1995-12-01 00:00:00
abstract::Fungal central nervous system infections present in a myriad of clinical manifestation and remain a significant diagnostic challenge. Presenting symptoms, cerebrospinal fluid analysis, conventional fungal serum markers and imaging correlates of disease are seldom sensitive or specific; fungal culture growth or histopa...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1688916
更新日期:2019-06-01 00:00:00
abstract::Severe brain injury may cause disruption of neural networks that sustain arousal and awareness, the two essential components of consciousness. Despite the potentially devastating immediate and long-term consequences, disorders of consciousness (DoC) are poorly understood in terms of their underlying neurobiology, the ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1607310
更新日期:2017-10-01 00:00:00
abstract::Listeria monocytogenes infection of the central nervous system is often not recognized and treated appropriately in the crucial early stages of the disease. Most consider patients with underlying disease or immunocompromised states to be at risk, although healthy individuals may present with a neurologic syndrome caus...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2000-9398
更新日期:2000-01-01 00:00:00
abstract::Multiple sclerosis (MS) affects more than 500,000 Americans, and it is commonly on the differential diagnosis associated with patient referrals to neurology offices. Diagnostically, there are several nuances to the established criteria. Understanding the usefulness of various tests and the potential diagnoses that can...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0029-1245004
更新日期:2010-02-01 00:00:00
abstract::Disorders of gait and balance are common in medicine and often lead to referral for neurologic evaluation. Because the maintenance of balance and normal gait are mediated by complex neurologic pathways as well as musculoskeletal, metabolic, and behavioral considerations, the list of possible contributing causes is ver...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1354601
更新日期:2013-07-01 00:00:00
abstract::There are many unique characteristics in elderly patients with epilepsy. The incidence of seizure in this age group is the highest of any age group and continues to increase as people live longer. Etiology of seizures is different than for adults and includes cerebrovascular disease, dementia, closed head injury, and ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1079338
更新日期:2008-07-01 00:00:00
abstract::The muscular dystrophies are disorders of progressive muscular degeneration and weakness. As a group they display clinical heterogeneity that reflects the heterogeneity of molecular mechanisms responsible for them, and range from congenital to adulthood onset. Recent advances in the field include improved methods of d...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1329199
更新日期:2012-07-01 00:00:00
abstract::Neuroimmunologic and systemic rheumatic diseases are frequently accompanied by inflammation of the eye, ocular adnexa, and orbital tissues. An understanding of the diverse forms of ophthalmic pathology in these conditions aids the clinician in making appropriate preventative, diagnostic, therapeutic, and prognostic de...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1390393
更新日期:2014-09-01 00:00:00
abstract::Blepharospasm is a focal dystonia characterized by involuntary, repetitive eye closure. Orofacial and oromandibular dystonia describe involuntary dystonic movements of orofacial and oromandibular musculature. Hemifacial spasm is characterized by repetitive synchronous contraction of facial nerve innervated muscles on ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1571952
更新日期:2016-02-01 00:00:00
abstract::The fields of neurology and psychiatry were originally practiced as a unitary model. As the fields dichotomized patients into "organic" and "functional," patients with medically unexplained symptoms fell between the borderlands. Despite their significant prevalence, somatoform disorders (SDs) are grossly under-recogni...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1223875
更新日期:2009-07-01 00:00:00
abstract::Rapidly progressive dementia (RPD) or cognitive decline is a common presenting complaint in neurology. While primary dementia is often a concern, other forms of reversible dementia must be thoroughly considered. This article focuses on the growing field of autoimmune encephalitis (AE) as it pertains to the differentia...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1678583
更新日期:2019-04-01 00:00:00
abstract::Telemedicine is the use of electronic communication methods, such as the telephone, the Internet, and videoconferencing, to exchange medical information from one geographic site to another. Telestroke is the use of telemedicine specifically for stroke care. A strokologist is a physician with the special skills require...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1268869
更新日期:2010-11-01 00:00:00
abstract::Pregnancy can precipitate new neurological diseases as a result of the alterations in physiology that accompany the pregnant state. The pregnant patient presenting with neurological problems poses both diagnostic and therapeutic challenges, often forcing the clinician to rely on neuroimaging as part of the workup. Thi...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-2007-991123
更新日期:2007-11-01 00:00:00