Unmet needs of multiple sclerosis patients in the community.

Background: There is no evidence that disease modifying therapies (DMTs) are beneficial in progressive (non-relapsing) MS. However, these patients may benefit from multidiscipliniary interventions, and require financial and community support. Non-pharmacological needs of MS patients may be overlooked during fund allocation, and identification of unmet needs is important to optimise care and inform governmental resource distribution.

Using atypical symptoms and red flags to identify non-demyelinating disease.

Background: Red flags and atypical symptoms have been described as being useful in suggesting alternative diagnoses to multiple sclerosis (MS) and clinically isolated syndrome (CIS); however, their diagnostic utility has not been assessed. The aim of this study was to establish the predictive value of red flags and the typicality/atypicality of symptoms at presentation in relation to the final diagnosis of patients referred with suspected MS.

Methods: All patients referred with suspected MS over a 3-year period were assessed by the typicality of the clinical presentation and the occurrence of red flags in relation to the eventual diagnosis.

The role of the clinical nurse specialist in MS: a literature review.

The purpose of this review was to determine the role of nurse specialists in multiple sclerosis (NSMS) in providing care for carers of people with multiple sclerosis (PwMS). The databases searched from inception to April 2010 include: CINAHL, PsycINFO, British Nursing Index, PubMed, AMED, Nursing and Allied Health Source, Academic Search Complete, Cochrane Library Database, Web of Knowledge, Ovid Nursing Database, Social Science Index, and Joanna Briggs Institute. Eighteen articles were included in the review.

Discontinuing disease-modifying therapy in progressive multiple sclerosis: can we stop what we have started?

Disease-modifying therapy is ineffective in disabled patients (Expanded Disability Status Scale [EDSS] > 6.5) with secondary progressive multiple sclerosis (MS) without relapses, or in primary progressive MS. Many patients with secondary progressive MS who initially had relapsing MS continue to use disease-modifying therapies.

Reactivation of BK polyomavirus in patients with multiple sclerosis receiving natalizumab therapy.

Natalizumab therapy in multiple sclerosis has been associated with JC polyomavirus-induced progressive multifocal leucoencephalopathy. We hypothesized that natalizumab may also lead to reactivation of BK, a related human polyomavirus capable of causing morbidity in immunosuppressed groups. Patients with relapsing remitting multiple sclerosis treated with natalizumab were prospectively monitored for reactivation of BK virus in blood and urine samples, and for evidence of associated renal dysfunction.

The patient knows best: significant change in the physical component of the Multiple Sclerosis Impact Scale (MSIS-29 physical).

Aim: The aims of this study were to determine the reliability, responsiveness and minimally important change score of the Multiple Sclerosis Impact Scale (MSIS)-29 physical using the Expanded Disability Status Scale (EDSS) as an anchor measure.

Methods: 214 patients with multiple sclerosis (MS) (EDSS 0-8.5) had concurrent MSIS-29 and EDSS assessments at baseline and at up to 4 years of follow-up.