Publications by authors named "Wilf-Yarkoni A"

Background And Objectives: Susac syndrome (SuS) is a rare disorder characterized by encephalopathy, branch retinal artery occlusion, and sensorineural hearing loss, often accompanied by vertigo. Recent updates to diagnostic criteria and treatment guidelines have been made. This study examines clinical manifestations; disease activity; and risk factors of disability, dependency, and return to work in patients with SuS.

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  • The study applied the 2022 international consensus criteria for optic neuritis (ICON) to 160 patients with acute optic neuritis to assess its effectiveness in classification.
  • About 50% of the patients were classified as definite optic neuritis, while 43% were not classified as having ON, mainly due to the absence of critical symptoms like relative afferent pupillary defect (RAPD) and dyschromatopsia.
  • The adjusted criteria led to a higher classification of 79% of patients as having optic neuritis, highlighting the importance of thorough examinations for accurate diagnosis.*
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Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune demyelinating disorder of the central nervous system. Optic neuritis (ON) is the most common clinical manifestation of MOGAD in adults. In 2023, new MOGAD diagnostic criteria were proposed, highlighting the importance of supplemental criteria when MOG-immunoglobulin G (IgG) titers are unavailable.

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  • The study investigates the safety of the BNT162b2 mRNA COVID-19 vaccine in multiple sclerosis (MS) patients, focusing on whether it causes any exacerbation of the disease as seen through MRI imaging.
  • A retrospective analysis of 84 MS patients revealed that those with early onset MS who were vaccinated had an increased risk of developing new lesions, while adult-onset patients did not show the same risk.
  • The findings generally indicate that the vaccine is safe for MS patients, but close monitoring via MRI is advised for those with early-onset MS due to the observed risks.
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Background: Detection of oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) is important for diagnosis of multiple sclerosis (MS). Previous studies reported that treatment with intravenous methylprednisolone (IVMP) before lumber puncture (LP) could suppress OCBs production. The aim of this study was to assess whether IVMP initiation prior to CSF collection affects OCBs results in patients with an acute demyelinating event.

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Susac syndrome (SuS) is an orphan microangiopathic disease characterized by a triad of encephalopathy, visual disturbances due to branch retinal artery occlusions, and sensorineuronal hearing loss. Our previous systematic review on all cases of SuS reported until 2012 allowed for a better understanding of clinical presentation and diagnostic findings. Based on these data, we suggested diagnostic criteria in 2016 to allow early diagnosis and treatment of SuS.

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Acute optic neuritis treatment lacks standardized protocols. The value of oral prednisone taper (OPT) following intravenous methylprednisolone (IVMP) on visual outcome parameters in optic neuritis (ON) has never been explored. In the present retrospective study, we investigated whether OPT after IVMP affects the structural and functional visual outcomes of inaugural clinically isolated syndrome (CIS)- or multiple sclerosis (MS)-ON.

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Cladribine tablets (Mavenclad) were approved by the European Union in 2017 as high-efficacy therapy for highly active relapsing-remitting multiple sclerosis. In Israel, Mavenclad was approved in 2018. Real-life experience has confirmed the efficacy of cladribine tablets over at least 4 years from the initial course.

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  • A study investigated the effectiveness of intravenous immunoglobulins (IVIGs) for treating acute myelin oligodendrocyte glycoprotein antibody disease (MOGAD) attacks.
  • The research involved analyzing data from 39 patients across seven neuroimmunology centers, focusing on patient demographics and symptoms before and after IVIG treatment.
  • Results showed significant improvements in disability and visual acuity following IVIG administration, suggesting it may be a beneficial treatment for MOGAD, although further studies are needed to confirm these findings.
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Objectives: In October 2020 and March 2021, the U.S. Food and Drug Administration (FDA) classified lamotrigine as a class IB antiarrhythmic, announcing an increased risk of heart rhythm problems.

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  • Optic neuritis (ON) often signals the onset of multiple sclerosis (MS) and other related disorders, with high-dose corticosteroids recommended for treatment but not adequately studied regarding timing and patient antibodies.
  • The Acute Optic Neuritis Network (ACON) aims to investigate how the timing of corticosteroid treatment affects visual outcomes 6 months post-ON onset by enrolling patients who present within 30 days of initial symptoms.
  • The study will collect extensive data on various ON subtypes and factors like visual acuity, imaging results, and patient-reported outcomes from 28 hospitals globally, targeting a recruitment of 200 patients across different ON classifications.
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Purpose: To evaluate the effectiveness of plasma exchange (PLEX) for optic neuritis (ON).

Methods: We conducted an international multicenter retrospective study evaluating the outcomes of ON following PLEX. Outcomes were compared to raw data from the Optic Neuritis Treatment Trial (ONTT) using a matched subset.

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Optic neuritis (ON) is a frequent presentation at onset of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). The pathophysiology underlying these diseases, especially MOGAD, is still being elucidated. While obesity has been reported to potentially be a risk factor for MS, this has not been explored in NMOSD or MOGAD.

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  • The study aimed to explore the timing of eye pain and visual loss in patients with optic neuritis associated with MOG-IgG and assess how early steroid treatment impacts recovery.
  • Researchers reviewed data from 107 patients and found that eye pain often occurred before vision loss, with those receiving early steroid treatment recovering faster and achieving better visual outcomes.
  • However, recovery without steroids was noted in some cases, indicating that further research through randomized clinical trials is necessary to confirm these findings.
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Background: Cerebrospinal fluid (CSF) oligoclonal bands (OCBs) are immunoglobulins that represent intrathecal synthesis during central nervous system infection or inflammation. As repeated lumbar puncture (LP) is usually not performed unless clinically indicated, there is very limited data on the natural history and course of OCBs status in the CSF, its relation to disease activity, duration of persistence, and the rate of either CSF conversion of OCBs or disappearance.

Methods: We retrospectively collected data from adult patients with various neurological syndromes who had repeated CSF samplings.

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Importance: Recent studies suggest that maintenance intravenous immunoglobulin (IVIG) may be an effective treatment to prevent relapses in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD); however, most of these studies had pediatric cohorts, and few studies have evaluated IVIG in adult patients.

Objective: To determine the association of maintenance IVIG with the prevention of disease relapse in a large adult cohort of patients with MOGAD.

Design, Setting, And Participants: This was a retrospective cohort study conducted from January 1, 2010, to October 31, 2021.

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Although the COVID-19 vaccines are currently recommended for people with myasthenia gravis (MG), there is no data regarding the safety of the vaccines in this population. In order to investigate the real-life safety data of the BNT162b2 COVID-19 vaccine in people with MG, an anonymous survey was distributed to 142 MG patients. Fifty-six MG patients completed the questionnaire.

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Background And Purpose: Although the COVID-19 vaccines are currently recommended for people with multiple sclerosis (MS), the fact that they were not specifically tested in people with MS raises uncertainty regarding their safety in this population. The purpose of this study was to report real-life safety data of the BNT162b2 COVID-19 vaccine in a cohort of MS patients.

Methods: An anonymous survey was distributed to 425 MS patients.

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Background: Susac's syndrome, a rare autoimmune vasculo-occlusive disease, may pose a diagnostic challenge and result in a devastating ocular and systemic outcome. Our study identifies a new retinal finding and evaluates disease outcome. We aimed to assess clinical and imaging findings, systemic manifestations and disease outcome in patients with ocular Susac's syndrome under immunosuppressive/immunomodulation therapies.

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Introduction: Intravenous immunoglobulin (IVIg) has been proven beneficial in myasthenic crisis, but their role as maintenance therapy is unclear. The aim of this study was to determine if maintenance therapy with low-dose IVIg improves clinical outcome and may be used as a steroid-sparing agent in myasthenia gravis (MG).

Methods: We retrospectively reviewed charts of all MG patients treated with IVIg from January 2006 to December 2019.

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  • * A review of 27 studies found that the risk of symptom exacerbation after CS treatment varies depending on the type of corticosteroid and its dosage, with cortisone causing the highest rate of exacerbations.
  • * Factors such as older age, severity of MG, and the presence of thymoma can increase the risk of exacerbation; however, current research is limited in quality and more targeted studies are needed to better understand the effects of different CS treatments.
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Background: Susac syndrome (SuS) is a rare condition characterized by a clinical triad of sensorineural hearing loss, branch artery occlusion and encephalopathy. This study reports an increased incidence of SuS in Israel. We describe the clinical characteristics of these patients, diagnostic procedures and the use and subsequent outcomes of newly published treatment guidelines.

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Objective: To investigate the hypothesis that free light chain (FLC) sera levels could serve as a biomarker for myasthenia gravis (MG), especially for the subgroups of seronegative MG and ocular MG.

Methods: Sera from 73 patients with MG (20 seronegative for antiacetylcholine receptor [AChR] and anti-muscle-specific kinase and 53 positive for anti-AChR, which were clinically divided into 24 patients with ocular type, 45 with generalized type, and 4 with unequivocal clinical manifestation) and 49 healthy controls were studied for κ FLC and λ FLC levels with the Freelite human FLC kits.

Results: The κ but not the λ levels of FLC were significantly increased in the patients with MG, including those with double seronegative MG and ocular MG, compared with the healthy controls.

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