Positive neurologic phenomena with initiation of dalfampridine for multiple sclerosis.

Objective: Review cases of positive neurologic phenomena initiated or worsened with dalfampridine in patients with multiple sclerosis.

Background: Oral, extended release dalfampridine (4-aminopyridine or 4-AP) is a potassium-channel blocker approved for the treatment of gait impairment in multiple sclerosis (MS). The enhanced conduction along demyelinated axons promoted by dalfampridine could potentially lead to development of positive neurologic phenomena.

Teaching neuroimages: dyspnea as a presenting manifestation of amyloid myopathy.

A 69-year-old man had dyspnea followed by slowly progressive proximal leg weakness over 2 years. He had macroglossia (figure 1). Creatine kinase was 1,378 U/L.

Is donepezil effective for multiple sclerosis-related cognitive dysfunction? A critically appraised topic.

Background: Cognitive dysfunction affects approximately half of the patients with multiple sclerosis (MS). Cholinesterase inhibitor drugs are approved to treat cognitive dysfunction associated with degenerative dementia.

Objective: To critically assess current evidence regarding the efficacy of the cholinesterase inhibitor, donepezil in the treatment of MS-associated cognitive impairment.

Are corticosteroid and antiviral treatments effective for bell palsy? A critically appraised topic.

Background: : Bell palsy is idiopathic peripheral facial weakness that typically resolves without severe clinical sequelae. Treatment with corticosteroids and antiviral drugs is often initiated to improve the likelihood of a favorable outcome.

Objective: : Are corticosteroid and antiviral medications effective in the treatment of Bell palsy?

Methods: : The objective was addressed through the development of a structured critically appraised topic.

Do cannabinoids reduce multiple sclerosis-related spasticity?

Background: The plant Cannabis sativa contains numerous cannabinoids, which are aromatic hydrocarbons that have central nervous system effects mediated through specific cannabinoid receptors. Some patients with multiple sclerosis (MS) report symptomatic relief from spasticity, pain, and other symptoms when using smoked cannabis, and small trials have suggested some symptomatic benefit.

Objective: Do cannabinoids improve spasticity in patients with MS?

Methods: We addressed the question through the development of a structured, critically appraised topic.