Abstract:
BACKGROUND:The novel coronavirus disease 2019 (COVID-19) pandemic poses a potential threat to patients with autoimmune disorders, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Such patients are usually treated with immunomodulatory or immunosuppressive agents, which may tamper with the organism's normal response to infections. Currently, no consensus has been reached on how to manage MS and NMOSD patients during the pandemic. OBJECTIVE:To discuss strategies to manage those patients. METHODS:We focus on how to 1) reduce COVID-19 infection risk, such as social distancing, telemedicine, and wider interval between laboratory testing/imaging; 2) manage relapses, such as avoiding treatment of mild relapse and using oral steroids; 3) manage disease-modifying therapies, such as preference for drugs associated with lower infection risk (interferons, glatiramer, teriflunomide, and natalizumab) and extended-interval dosing of natalizumab, when safe; 4) individualize the chosen MS induction-therapy (anti-CD20 monoclonal antibodies, alemtuzumab, and cladribine); 5) manage NMOSD preventive therapies, including initial therapy selection and current treatment maintenance; 6) manage MS/NMOSD patients infected with COVID-19. CONCLUSIONS:In the future, real-world case series of MS/NMOSD patients infected with COVID-19 will help us define the best management strategies. For the time being, we rely on expert experience and guidance.
journal_name
Arq Neuropsiquiatrjournal_title
Arquivos de neuro-psiquiatriaauthors
ApÓstolos-Pereira SL,Silva GD,Disserol CCD,Feo LB,Matos AMB,Schoeps VA,Gomes ABAGR,Boaventura M,Mendes MF,Callegaro Ddoi
10.1590/0004-282X20200056subject
Has Abstractpub_date
2020-07-01 00:00:00pages
430-439issue
7eissn
0004-282Xissn
1678-4227pii
S0004-282X2020005015202journal_volume
78pub_type
杂志文章abstract::The post-polio syndrome (PPS) is an entity characterized for an episode of muscular weakness and/or abnormal muscular fatigue in individuals that had presented acute polio years before. We report the case of PPS in a patient, 40 years, that thirty-five years after had had paralytic poliomyelitis, developed new symptom...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2007000300033
更新日期:2007-06-01 00:00:00
abstract::With the increase in life expectancy in Brazil, concerns have grown about the most prevalent diseases in elderly people. Among these diseases are neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases. Protein deposits related to the development of these diseases can pre-date the symptomatic phases b...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/0004-282X20150066
更新日期:2015-07-01 00:00:00
abstract::We report on 15 cases of medulloblastoma of adult onset (8 male and 7 female) operated upon posterior fossa approach from February 1988 to October 1995. Tumors were localized in cerebellar hemisphere in 7 cases (one with extension to supratentorial notch and another case reaching the cerebello-pontine angle cistern), ...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1999000600014
更新日期:1999-12-01 00:00:00
abstract::Using the clinical quantification of the neurologic symptomatology the authors made observations and avaliated the action of Ciba 34.647-Ba, a GABA derivative, in 12 patients suffering from spasticity and motor incapacity due to spinal cord lesions. The results are reported emphasizing the effects of the drug on the m...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1977000400008
更新日期:1977-12-01 00:00:00
abstract::Headache is a common complaint with a high prevalence in ambulatory settings. The physical and neurological examinations are frequently normal. The use of questionnaires as a screening methods for patients with primary headache could facilitate the diagnosis in non-specialized medical centers. In the present study, we...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1997000300003
更新日期:1997-09-01 00:00:00
abstract::We report on four cases of primary orthostatic tremor. The purpose of this study is the rarity of this type of tremor and the differential diagnosis with other tremors. The electrophysiological study showed a 15-20 Hz tremor frequency in our cases. There are clinical, electrophysiological and therapeutic differences o...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2000000100022
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Rett syndrome (RS) is a severe neurodevelopmental X-linked dominant disorder caused by mutations in the MECP2 gene. PURPOSE:To search for point mutations on the MECP2 gene and to establish a correlation between the main point mutations found and the phenotype. METHOD:Clinical evaluation of 105 patients, fo...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2009000400001
更新日期:2009-09-01 00:00:00
abstract::The aim of present study was to evaluate the number and basophily of cell bodies of myenteric neurons in the ileum of rats with diabetes mellitus induced by streptozotocin. Four groups of rats were used: diabetes was induced in two (D) whereas the other two worked as controls (N). Animals were sacrificed six (6N, 6D) ...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2000000600010
更新日期:2000-12-01 00:00:00
abstract::Neuromyelitis of cyanocobalamin deficiency (group 1) post vaccination myelopathy (group 2), multiple sclerosis and neuromyelitis optica (group 3) are studied comparatively as to the respective cerebrospinal fluid changes on cytology, proteins and gamma globulins. Changes were found to be more intense and frequent in t...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1981000300005
更新日期:1981-09-01 00:00:00
abstract::Many authors have studied physical and functional changes in individuals post-stroke, but there are few studies that assess changes in the non-plegic side of hemiplegic subjects. This study aimed to compare the electromyographic activity in the forearm muscles of spastic patients and clinically healthy individuals, to...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2010000400016
更新日期:2010-08-01 00:00:00
abstract:AIM:To evaluate smell recognition in pervasive developmental disorders (PDD). METHOD:Twenty-one PDD (experimental group) and 21 matched controls (control group) male adolescents were submitted to a standardized, 12-stimuli, smell battery in three moments: with no identification suggestion; associated to four linguisti...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2007000700021
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To assess the functional capacity and to determine the difference between the means of functional capacity (basic and instrumental activities of daily living) and the age groups of elderly residents in an outlying area in the hinterland of Bahia/Northeast of Brazil. METHOD:Analytical study with cross-section...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2010000100009
更新日期:2010-02-01 00:00:00
abstract::An 81-year-old woman developed left hemiplegia and coma due to a right hemisphere infarct and died 6 days later. When first seen in coma she had the classical signs of descending central herniation in the diencephalic stage. The CT scan of the third day showed a large hypodense area occupying the superficial and deep ...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1995000500019
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To assess the long-term efficacy of percutaneous vertebroplasty for the treatment of pain resulting from osteoporotic vertebral fractures. METHOD:26 percutaneous vertebroplasty procedures were performed for osteoporotic vertebral fractures in 15 patients during the period between July 2001 and May 2004. Befo...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2007000300023
更新日期:2007-06-01 00:00:00
abstract::Neurocysticercosis is a serious public health problem that predominantly affects places with poor sanitary and hygiene conditions. The Piaui State is out of the neurocysticercosis map in Brazil but, as this study illustrates, it is just by lack of epidemiologic data. We demonstrate the presence of this pathology in th...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2006000200030
更新日期:2006-06-01 00:00:00
abstract::Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. The different clinical presentations of the disease are determined by the quality of the host immune response. Early detection of leprosy and treatment by multidrug therapy are the most important steps in preventing deformity and dis...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章,评审
doi:10.1590/0004-282X20130146
更新日期:2013-09-01 00:00:00
abstract:Objective:The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas. Methods:A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as ba...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/0004-282X20170035
更新日期:2017-05-01 00:00:00
abstract::The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs sugge...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章,评审
doi:10.1590/s0004-282x1993000200018
更新日期:1993-06-01 00:00:00
abstract::Coronary heart disease and ischemic stroke are frequent coexistent conditions that share risk factors and pose major burdens to global health. Even though a clear relation has been established between extracranial internal carotid artery atherosclerosis and symptomatic or asymptomatic coronary heart disease, there is ...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章,评审
doi:10.1590/0004-282x20130028
更新日期:2013-05-01 00:00:00
abstract::Multiple sclerosis (MS) is an inflammatory, autoimmune, demyelinating, and degenerative central nervous system disease. Even though the etiology of MS has not yet been fully elucidated, there is evidence that genetic and environmental factors interact to cause the disease. Among the main environmental factors studied,...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 共识发展会议,杂志文章
doi:10.1590/0004-282X20130252
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Painful shoulder is considered the most common complication of hemiplegic/parethic (H/P) stroke patients. It is a negative factor for neuromotor recovery. PURPOSE:To study the effects of kinesiotherapy treatment on shoulder pain prevention, and as a secondary endpoints, to analyze muscle strength of H/P sho...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2003000500012
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To characterize neurological involvement in juvenile systemic lupus erythe-matosus. METHOD:The charts of all patients with the diagnosis of systemic lupus erythematosus before the age of 16 years, followed at the Rheumatology Unit of Pequeno Príncipe Hospital, from January 1992 to January 2006, were retrospe...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2007000300013
更新日期:2007-06-01 00:00:00
abstract::Significant advances in the understanding and management of Duchenne muscular dystrophy (DMD) have occurred since the publication of international guidelines for DMD care in 2010. Our objective was to provide an evidence-based national consensus statement for multidisciplinary care of DMD in Brazil. A combination of t...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章,评审
doi:10.1590/0004-282X20180062
更新日期:2018-07-01 00:00:00
abstract::In a seven year time period (July 1984 to June 1991) were studied CSF samples of 36,216 new patients, 470 of them infected by HIV. Number of AIDS patients represents 1.30% of total cases examined in the laboratory during this time period. Normal CSF was observed in only 16 cases (3.4%). Associated pathologies occurred...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1992000100010
更新日期:1992-03-01 00:00:00
abstract::The temporal medial sclerosis (TMS) is characterized by hippocampal sclerosis in temporal and by distinguished grades of injury near to other neurological structures such as: amygdaloid nucleus, parahippocampal girus and entorhinal region. The study analyzed 40 patients with TMS and 40 people from the control cluster....
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2006000400023
更新日期:2006-09-01 00:00:00
abstract::The authors emphasize the importance of computed tomography (CT) in the diagnosis of neurocysticercosis. Before CT, neurocysticercosis was considered rare in the Northeast Brazil. They reviewed fifteen cases diagnosed as neurocysticercosis by CT at the Institute of Radiology, in Natal. A case of neurocysticercosis dia...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1993000400021
更新日期:1993-12-01 00:00:00
abstract::The functional significance of MRI-defined mesial temporal sclerosis in temporal lobe epilepsy (TLE) is not completely established. In order to study the possible relationship between signals of mesial temporal sclerosis on MRI and interictal SPECT findings we selected 18 patients with complex partial seizures, unilat...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x1994000300002
更新日期:1994-09-01 00:00:00
abstract::We report the clinical, epidemiological and pathological findings of 28 patients with medulloblastoma: 22 were male; age ranged from 1 to 50 years, with a mean of 15 years. The most frequent symptoms and signs were headache (64%) and vomiting (64%). Only one patient showed a desmoplastic medulloblastoma variant, the o...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/s0004-282x2000000100012
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To report 4 different neurological complications of H1N1 virus vaccination. METHOD:Four patients (9, 16, 37 and 69 years of age) had neurological symptoms (intracranial hypertension, ataxia, left peripheral facial palsy of abrupt onset, altered mental status, myelitis) starting 4-15 days after H1N1 vaccinati...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:10.1590/0004-282x20140064
更新日期:2014-07-01 00:00:00
abstract::A case of central nervous system histoplasmosis located at the pons is reported. The authors point out difficulties for the diagnosis of the pathology during life and some aspects of the treatment and their results. The rarity of the process is emphasized. ...
journal_title:Arquivos de neuro-psiquiatria
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00