Navigating the discontinuation of multiple sclerosis first line treatments: A paradigm shift in patient care.

Background: This retrospective study, conducted between 2005 and 2016, investigated the outcomes of patients with multiple sclerosis (MS) who discontinued injectable first-line disease-modifying therapies (DMTs). The study aimed to identify factors influencing treatment discontinuation and assess the impact of discontinuation on disease progression.

Methods: Data was collected from 2,270 patients who received injectable DMTs for at least two years and subsequently discontinued treatment due to clinical and MRI remission, side effects, or noncompliance.

Cognitive impairment and affective disorder: A rare presentation of cerebellar stroke.

The awareness of the "Cerebellar Cognitive Affective Syndrome" (CCAS) as a clinical entity is emerging. The CCAS is characterized by impaired executive functions, linguistic skills, visuospatial cognition and personality change. Here we report a 56-year-old, male teacher who developed acute psychomotor retardation, low energy level, infrequent speech, and mild cognitive decline.