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1. Urinary tract infections and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

C. Donzé, C. Papeix, C. Lebrun-Frenay, C. Lebrun-Frénay, N. Collongues, M. de Seze, A. Dinh, A. Even, C. Scheiber-Nogueira, C. Bensa, B. Bourre, C. Carra-Dallière, J. Ciron, M. Cohen, A.M. Guennoc, C. Louapre, F. Lebreton, L. Michel, E. Maillart, B. Audoin, X. Ayrignac, P. Bernady, B. Brochet, P. Clavelou, R. Colamarino, A. Declemy, J. de Seze, N. Derache, J.-M. Faucheux, O. Heinzlef, P. Labauge, D. Laplaud, E. Lepage, E. Leray, L. Magy, G. Mathey, C. Mekies, V. Mondain, E. Planque, J. Pelletier, S. Pittion, B. Stankhof, P. Tournaire, E. Thouvenot, S. Vukusic, S. Wiertlevski, H. Zephir, H. Alchaar, G. Androdias, M. Benazet, D. Bensmail, D. Biotti, A. Blanchard-Dauphin, M. Bonnan, C. Boutière, P. Branger, S. Bresch, J.-P. Bru, J.-P. Camdessanché, E. Castel Canal, M. Coustans, O. Casez, B. Castan, A. Creange, E. Creisson, T. De Broucker, R. Depaz, X. Douay, C. Dulau, F. Durand-Dubief, O. Fagniez, M. Faucher, A. Floch, M. Fournier, A. Fromont, P. Gallien, X. Gamé, D. Gault, A. Gayou, M. Giroux, O. Gout, J. Grimaud, P. Hautecoeur, A. Kerbrat, L. Kremer, A. Kwiatkowski, C. Labeyrie, S. Lachaud, C. Lanctin-Garcia, L. Lanotte, E. Manchon, A. Maurousset, A.-M. Milor, X. Moisset, A. Mont-Cuquet, T. Moreau, J.-C. Ouallet, I. Patry, D. Peaureaux, M.-C. Pouget, V. Pourcher Martinez, C. Radot, A. Ruet, C. Saint-Val, A. Salmon, F. Taithe, P. Tatevin, M. Vaillant, J.-P. Stahl, F. Vuoto, C. Zaenker, Hôpital Saint Philibert [Lomme], Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Groupe Hospitalier de l'Institut Catholique de Lille (GHICL), Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Nice Sophia Antipolis (... - 2019) (UNS), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
medicine.medical_specialty, Urinary system, Population, MESH: Urinary Tract Infections, urologic and male genital diseases, Practice guidelines, Hypogammaglobulinemia, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, MESH: Pregnancy, Health care, medicine, Urinary tracts infections, In patient, 030212 general & internal medicine, Intensive care medicine, education, Asymptomatic bacteriuria, Pregnancy, education.field_of_study, MESH: Humans, Disease modifying therapy, business.industry, MESH: Multiple Sclerosis, medicine.disease, female genital diseases and pregnancy complications, 3. Good health, MESH: Recurrence, Neurology, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Neurology (clinical), business, MESH: Female, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Objectives Establish recommendations for the management of UTIs in MS patients. Background Urinary tract infections (UTIs) are common during multiple sclerosis (MS) and are one of the most common comorbidities potentially responsible for deaths from urinary sepsis. Methods The recommendations attempt to answer three main questions about UTIs and MS. The French Group for Recommendations in MS (France4MS) did a systematic review of articles from PubMed and universities databases (01/1980–12/2019). The RAND/UCLA appropriateness method, which has been developed to synthesize the scientific literature and expert opinions on health care topics, was used for reaching a formal agreement. 26 MS experts worked on the full-text review and a group of 70 multidisciplinary health care specialists validated the final evaluation of summarized evidences. Results UTIs are not associated with an increased risk of relapse and permanent worsening of disability. Only febrile UTIs worsen transient disability through the Uhthoff phenomenon. Some immunosuppressive treatments increase the risk of UTIs in MS patients and require special attention especially in case of hypogammaglobulinemia. Experts recommend to treat UTIs in patients with MS, according to recommendations of the general population. Prevention of recurrent UTIs requires stabilization of the neurogenic bladder. In some cases, weekly oral cycling antibiotics can be proposed after specialist advice. Asymptomatic bacteriuria should not be screened for or treated systematically except in special cases (pregnancy and invasive urological procedures). Conclusion Physicians and patients should be aware of the updated recommendations for UTis and MS.

Published
2020
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2. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Author

C. Lebrun, S. Vukusic, V. Abadie, C. Achour, F. Ader, H. Alchaar, A. Alkhedr, F. Andreux, G. Androdias, R. Arjmand, B. Audoin, D. Audry, D. Aufauvre, C. Autreaux, X. Ayrignac, M. Bailbe, M. Benazet, C. Bensa, D. Bensmail, E. Berger, P. Bernady, Y. Bertagna, D. Biotti, A. Blanchard-Dauphin, J. Bonenfant, M. Bonnan, B. Bonnemain, F. Borgel, E. Botelho-Nevers, S. Boucly, B. Bourre, C. Boutière, P. Branger, D. Brassat, S. Bresch, V. Breuil, B. Brochet, H. Brugeilles, P. Bugnon, P. Cabre, J.-P. Camdessanché, C. Carra-Dalière, O. Casez, J.-M. Chamouard, B. Chassande, P. Chataignier, M. Chbicheb, A. Chenet, J. Ciron, P. Clavelou, M. Cohen, R. Colamarino, N. Collongues, I. Coman, P.-R. Corail, S. Courtois, M. Coustans, A. Creange, E. Creisson, N. Daluzeau, C. Davenas, J. De Seze, M. Debouverie, R. Depaz, N. Derache, L. Divio, X. Douay, C. Dulau, F. Durand-Dubief, G. Edan, Z. Elias, O. Fagniez, M. Faucher, J.-M. Faucheux, M. Fournier, A. Gagneux-Brunon, P. Gaida, P. Galli, P. Gallien, J. Gaudelus, D. Gault, A. Gayou, M. Genevray, A. Gentil, J. Gere, L. Gignoux, M. Giroux, P. Givron, O. Gout, J. Grimaud, A.-M. Guennoc, N. Hadhoum, P. Hautecoeur, O. Heinzlef, M. Jaeger, S. Jeannin, L. Kremer, A. Kwiatkowski, P. Labauge, C. Labeyrie, S. Lachaud, I. Laffont, C. Lanctin-Garcia, J. Lannoy, L. Lanotte, D. Laplaud, D. Latombe, M. Lauxerois, E. Le Page, C. Lebrun-Frenay, P. Lejeune, P. Lejoyeux, B. Lemonnier, E. Leray, C.-M. Loche, C. Louapre, C. Lubetzki, A. Maarouf, B. Mada, L. Magy, E. Maillart, E. Manchon, R. Marignier, P. Marque, G. Mathey, A. Maurousset, C. Mekies, M. Merienne, L. Michel, A.-M. Milor, X. Moisset, A. Montcuquet, T. Moreau, N. Morel, M. Moussa, J.-P. Naudillon, M. Normand, P. Olive, J.-C. Ouallet, O. Outteryck, C. Pacault, C. Papeix, I. Patry, D. Peaureaux, J. Pelletier, B. Pichon, S. Pittion, E. Planque, M.-C. Pouget, V. Pourcher, C. Radot, I. Robert, F. Rocher, A. Ruet, C. Saint-Val, J.-Y. Salle, A. Salmon, E. Sartori, S. Schaeffer, B. Stankhof, F. Taithe, E. Thouvenot, C. Tizon, A. Tourbah, P. Tourniaire, M. Vaillant, P. Vermersch, S. Vidil, A. Wahab, M.-H. Warter, S. Wiertlewski, B. Wiplosz, B. Wittwer, C. Zaenker, H. Zephir, Université Côte d'Azur (UCA), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre de recherche en neurosciences de Lyon (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hosp Civils Lyon, Serv Malad Infect, Lyon, France, Biogéosciences [UMR 6282] [Dijon] (BGS), Centre National de la Recherche Scientifique (CNRS)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Pontchaillou [Rennes], CHU Saint-Etienne, Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - AP-HM] (CEMEREM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), Comité de Développement Horticole du Centre Val de Loire (CDHRC), Génétique, physiopathologie et ingénierie du tissu osseux (GéPITOS), Centre National de la Recherche Scientifique (CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA), Service d'Etudes du Comportement des Matériaux de Conditionnement (SECM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Galaxies, Etoiles, Physique, Instrumentation (GEPI), Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [Rennes] = Neurology [Rennes], Excitabilité nerveuse et thérapeutique (ENT), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-EA 4391, Service de Physiologie Explorations Fonctionnelles-Hôpital Henri Mondor, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Combustion Research Facility, Sandia National Laboratories - Corporation, Service de Pédiatrie [Jean Verdier], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Kuriwa Observatory, Fondation Ophtalmologique Adolphe de Rothschild [Paris], Laboratoire de Mécanique, Modélisation et Procédés Propres (M2P2), Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Euromov (EuroMov), Université de Montpellier (UM), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Biologie des Interactions Neurones / Glie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Neurologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire d'automatique et de génie des procédés (LAGEP), Université de Lyon-Université de Lyon-École Supérieure Chimie Physique Électronique de Lyon-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Haras National Suisse, Centre Hospitalier Universitaire de Reims (CHU Reims), Center for health studies, Service de neurologie [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Hospices Civils de Lyon, Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Biogéosciences [UMR 6282] (BGS), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Hôpital Henri Mondor-EA 4391, Service de Physiologie Explorations Fonctionnelles-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM] (CEMEREM), Comité de développement horticole de la région Centre-Val-de-Loire (CDHR CENTRE-VAL-DE-LOIRE), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-Université Côte d'Azur (UCA), Service de Neurologie [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut d’Électronique, de Microélectronique et de Nanotechnologie (IEMN) - UMR 8520 (IEMN), Ecole Centrale de Lille-Institut supérieur de l'électronique et du numérique (ISEN)-Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Université Polytechnique Hauts-de-France (UPHF), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Neurologie [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-IFR70-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie, CHU Clermont-Ferrand, Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
medicine.medical_specialty, Vaccination schedule, MEDLINE, Scientific literature, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Risk Factors, Health care, Medicine, Humans, 030212 general & internal medicine, Immunization Schedule, Societies, Medical, Vaccines, business.industry, Risk of infection, Prevention, Vaccination, medicine.disease, 3. Good health, Neurology, Immunization, Family medicine, Evidence-Based Practice, Practice Guidelines as Topic, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), France, business, Infection, Vaccine, 030217 neurology & neurosurgery
Abstract

Objectives To establish recommendations on immunization for patients with multiple sclerosis (MS). Background Vaccines have been suspected in the past to trigger MS and relapses. With the extension of the immunoactive treatment arsenal, other concerns have been raised more recently about an increased risk of infection or a decreased effectiveness of immunization in immunosuppressed patients. Methods The French Group for Recommendations into Multiple Sclerosis (France4MS) performed a systematic search of papers in Medline and other university databases (January 1975–June 2018). The RAND/UCLA appropriateness method was chosen to review the scientific literature and to formalize the degree of agreement among experts on 5 clinical questions related to immunization and MS. Readers from the steering committee conducted a systematic analysis, wrote a critical synthesis and prepared a list of proposals that were evaluated by a rating group of 28 MS experts. The final version of the recommendations was finally reviewed by a reading group of 110 health care professionals and classified as appropriate, inappropriate or uncertain. Results Neurologists should verify the vaccination status as soon as MS is diagnosed and before disease-modifying treatments (DMTs) are introduced. The French vaccination schedule applies to MS patients and seasonal influenza vaccination is recommended. In the case of treatment-induced immunosuppression, MS patients should be informed about the risk of infection and the vaccination standards of the French High Council of Health should be applied. Live attenuated vaccines are contra-indicated in patients recently treated with immunosuppressive drugs, including corticosteroids; other vaccines can be proposed whatever the treatment, but their effectiveness may be partly reduced with some drugs. Conclusion Physicians and patients should be aware of the updated recommendations for immunizations of patients with MS.

Published
2019
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3. Rapidly progressive amyotrophic lateral sclerosis initially masquerading as a demyelinating neuropathy

Author

Alain Créange, C. Saint-Val, Rechdi Ahdab, Wassim H. Farhat, and Jean-Pascal Lefaucheur

Subjects
Male, Pathology, medicine.medical_specialty, Wallerian degeneration, Neural Conduction, Motor nerve, Chronic inflammatory demyelinating polyneuropathy, Diagnosis, Differential, Upper Extremity, Physiology (medical), medicine, Humans, Peripheral Nerves, Amyotrophic lateral sclerosis, Cerebral Cortex, Motor Neurons, Neurologic Examination, Muscle Weakness, medicine.diagnostic_test, Electromyography, business.industry, Amyotrophic Lateral Sclerosis, Magnetic resonance imaging, General Medicine, Middle Aged, Motor neuron, medicine.disease, Axons, Electric Stimulation, Electrophysiological Phenomena, Compound muscle action potential, medicine.anatomical_structure, Lower Extremity, Neurology, Nerve Degeneration, Female, Neurology (clinical), Spinal Nerve Roots, business, Neuroscience, Demyelinating Diseases, Multifocal motor neuropathy
Abstract

Rare cases of demyelinating neuropathy have been described in association with amyotrophic lateral sclerosis (ALS). We report two patients with typical ALS whose initial electroneuromyographic (ENMG) presentation could suggest the existence of a process of motor nerve fiber demyelination. However, subsequent ENMG examinations and the fatal course of the disease in a few months rather supported severe ongoing axonal degeneration at the origin of motor nerve conduction abnormalities. Repeated examinations could be required to distinguish between ENMG features of concomitant demyelinating neuropathy and rapidly progressive motor neuron loss in ALS.

Published
2013
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5. Peripheral neuropathies after arthropod stings not due to Lyme disease: a report of five cases and review of the literature

Author

Romain K. Gherardi, Alain Créange, Jean-Denis Degos, Loïc Guillevin, and C. Saint-Val

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Wallerian degeneration, Adolescent, Neural Conduction, Mononeuropathy, Lyme disease, Borrelia burgdorferi Group, medicine, Animals, Humans, Bites and Stings, Arthropods, Aged, Lyme Disease, business.industry, Insect Bites and Stings, Peripheral Nervous System Diseases, Middle Aged, medicine.disease, Peripheral neuropathy, Lyme disease microbiology, Female, Neurology (clinical), Complication, business, Vasculitis, Polyneuropathy
Abstract

Five patients developed neurologic symptoms a few hours to 2 months after being stung by a non-hooking arthropod with immediate cutaneous reaction. The patients had no clinical or serologic evidence for Lyme borreliosis and rickettsial disease. Clinical and electrophysiologic findings were consistent with a mixed axonal and demyelinating mononeuropathy, a monomelic multiple mononeuropathy, a mononeuropathy multiplex, a radiculoneuritis, and a distal symmetric polyneuropathy. Muscle and nerve biopsies showed lymphoplasmacytic small-vessel vasculitis in all patients, and wallerian degeneration in three. These patients, and 17 others from the literature, indicate a spectrum of peripheral neuropathies occurring after insect and spider stings.

Published
1993

7. Acute demyelinating disease after interferon -1a treatment for multiple sclerosis

Author

Pierre Cesaro, Pierre Brugières, C. Saint Val, F. Von Raison, and H. Abboud

Subjects
Adult, Male, medicine.medical_specialty, Neurological disorder, Gastroenterology, Central nervous system disease, Multiple Sclerosis, Relapsing-Remitting, Internal medicine, Demyelinating disease, Humans, Medicine, Tetraplegia, business.industry, Multiple sclerosis, Interferon beta-1a, Interferon-beta, medicine.disease, Magnetic Resonance Imaging, Surgery, Methylprednisolone, Neurology (clinical), business, Paraplegia, Demyelinating Diseases, medicine.drug
Abstract

Recombinant human interferon (INFβ) benefits both relapsing-remitting and secondary progressive MS.1,2⇓ INFβ usually is well tolerated; the most common side effects are transient, flu-like symptoms and injection site reactions.3 We report a case of quadriplegia and brain stem disease probably related to an acute demyelinating process after the first injection of INFβ-1a. A 21-year-old man with relapsing-remitting MS was referred for paraplegia and weakness. When MS was first diagnosed in July 1998, he presented with paresthesia and weakness of the left upper extremity, and he was successfully treated with IV methylprednisolone. Cerebral MRI showed small demyelinating lesions of the white matter (figure, A through C), and CSF analysis detected oligoclonal bands of IgG. A few months later, he presented with the same symptoms and again responded to IV methylprednisolone. One month later, INFβ-1a was initiated …

Published
2000
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8. [Isolated paralysis of the ocular motor nerve caused by infarction of fascicular fibers]

Author

M, Collard, C, Saint-Val, M, Mohr, and M, Kiesmann

Subjects
Aged, 80 and over, Tegmentum Mesencephali, Oculomotor Nerve Diseases, Brain, Humans, Female, Cerebral Infarction, Tomography, X-Ray Computed, Aged
Abstract

We report the case of an 80 year-old woman who developed an unilateral brainstem infarction with a lesion of the intraparenchymatous fibres of the IIIrd cranial nerve. Intraaxial lesions of this nerve are usually part of the alternate paralysis syndrome. Our case might be the second since the report of Achard and Levi in 1901. Infarction limited to the fascicular fibres of the oculomotor nerve sparing the oculomotor nuclei results in characteristic clinical manifestations. This in turn results from the highly selective distribution of the terminal arterial territories in the midbrain.

Published
1990

9. [A case of Purtscher's syndrome; angiographic and therapeutic aspects]

Author

J, Peyresblanques, C, Saint Val, B B, Poletto, J L, Chenut, A M, Dussarte, and P, Duvezin-Caubet

Subjects
Adult, Male, Cytidine Diphosphate Choline, Retinal Diseases, Edema, Humans, Retinal Hemorrhage, Retinal Vessels, Syndrome, Fluorescein Angiography
Published
1978

10. [A case of the Vogt-Koyanagi-Harada syndrome]

Author

J, Peyresblanques, C, Saint Val, and J P, Collin

Subjects
Adult, Cortisone, Uveitis, Choroid, Electroretinography, Retinal Detachment, Humans, Female, Fluorescein Angiography, Uveomeningoencephalitic Syndrome
Published
1984

14. Injection of interferon-beta in the morning decreases flu-like syndrome in many patients with multiple sclerosis.

Author

Nadjar Y, Coutelas E, Prouteau P, Panzer F, Paquet D, Saint-Val C, and Créange A

Subjects
Antipyretics administration & dosage, Antipyretics therapeutic use, Cohort Studies, Humans, Interferon Type I therapeutic use, Interleukin-6 metabolism, Multiple Sclerosis drug therapy, Recombinant Proteins, Sleep drug effects, Surveys and Questionnaires, Time Factors, Treatment Outcome, Influenza, Human drug therapy, Interferon Type I administration & dosage, Interferon Type I adverse effects, Multiple Sclerosis complications
Abstract

Background: Although it is recommended that interferon-beta (IFNβ) injections be administered in the evening, it is possible that morning injections could more effectively decrease interleukin 6 secretion., Methods: This study evaluated the effects of switching from an evening injection of IFNβ to a morning injection on the intensity of flu-like syndrome in patients with multiple sclerosis (MS). We performed an intervention study that consisted of a quantitative evaluation of IFNβ-related flu-like syndrome in a cohort of 105 MS patients. Patients with persistent flu-like reactions who injected IFNβ in the evening were encouraged to switch to morning injections. After one month, we evaluated various quantitative and qualitative changes (e.g., severity of flu-like syndrome, sleep quality, antipyretic drug use)., Results: Of the 98 patients (93%) who injected IFNβ in the evening, 88 (85%) had a persistent flu-like syndrome (the severity score was 3.92±0.26). A total of 50 (57%) patients switched to morning injections. One month after changing the injection time, 29 patients (58%) reported that their flu-like syndrome was decreased, 11 (24%) thought that it was unchanged and 9 (18%) thought that it was increased (p=0.014). In addition, 23 patients (48%) reported improved sleep (p=0.001), and 33 (68%) patients chose to continue morning injections, whereas 17 (32%) patients switched back to evening injections (p=0.024). Quantitative measures, however, indicated that there was no change in the severity of flu-like syndrome or the number of antipyretic doses taken for its management., Conclusion: Morning injections qualitatively improved IFNβ-related flu-like syndrome and sleep. A change in IFNβ injection time from evening to morning could benefit a significant proportion of patients with MS., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Published
2011
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15. Peripheral neuropathies after arthropod stings not due to Lyme disease: a report of five cases and review of the literature.

Author

Créange A, Saint-Val C, Guillevin L, Degos JD, and Gherardi R

Subjects
Adolescent, Adult, Aged, Animals, Bites and Stings microbiology, Borrelia burgdorferi Group isolation & purification, Female, Humans, Lyme Disease complications, Lyme Disease microbiology, Male, Middle Aged, Neural Conduction, Peripheral Nervous System Diseases physiopathology, Arthropods, Insect Bites and Stings complications, Peripheral Nervous System Diseases etiology
Abstract

Five patients developed neurologic symptoms a few hours to 2 months after being stung by a non-hooking arthropod with immediate cutaneous reaction. The patients had no clinical or serologic evidence for Lyme borreliosis and rickettsial disease. Clinical and electrophysiologic findings were consistent with a mixed axonal and demyelinating mononeuropathy, a monomelic multiple mononeuropathy, a mononeuropathy multiplex, a radiculoneuritis, and a distal symmetric polyneuropathy. Muscle and nerve biopsies showed lymphoplasmacytic small-vessel vasculitis in all patients, and wallerian degeneration in three. These patients, and 17 others from the literature, indicate a spectrum of peripheral neuropathies occurring after insect and spider stings.

Published
1993
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17. [African Lyme disease].

Author

Ginsburg C, Saint-Val C, Eizenbaum JF, and Degos JD

Subjects
Burkina Faso epidemiology, Humans, Male, Middle Aged, Lyme Disease epidemiology
Published
1991

18. Thalamic infarction following lingual herpes zoster.

Author

Geny C, Yulis J, Azoulay A, Brugieres P, Saint-Val C, and Degos JD

Subjects
Aged, Cerebral Infarction diagnostic imaging, Humans, Male, Tomography, X-Ray Computed, Cerebral Infarction etiology, Herpes Zoster complications, Thalamus blood supply, Tongue Diseases complications
Published
1991
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20. [2 cases of regional neuritis after insect stings].

Author

Saint-Val C, Gherardi R, Malapert D, Mann M, and Degos JD

Subjects
Adolescent, Electromyography, Female, Humans, Male, Middle Aged, Insect Bites and Stings complications, Neuritis etiology
Published
1990

21. [Isolated paralysis of the ocular motor nerve caused by infarction of fascicular fibers].

Author

Collard M, Saint-Val C, Mohr M, and Kiesmann M

Subjects
Aged, Aged, 80 and over, Brain pathology, Cerebral Infarction pathology, Female, Humans, Oculomotor Nerve Diseases pathology, Tegmentum Mesencephali pathology, Tomography, X-Ray Computed, Cerebral Infarction complications, Oculomotor Nerve Diseases etiology, Tegmentum Mesencephali blood supply
Abstract

We report the case of an 80 year-old woman who developed an unilateral brainstem infarction with a lesion of the intraparenchymatous fibres of the IIIrd cranial nerve. Intraaxial lesions of this nerve are usually part of the alternate paralysis syndrome. Our case might be the second since the report of Achard and Levi in 1901. Infarction limited to the fascicular fibres of the oculomotor nerve sparing the oculomotor nuclei results in characteristic clinical manifestations. This in turn results from the highly selective distribution of the terminal arterial territories in the midbrain.

Published
1990

23. [A case of the Vogt-Koyanagi-Harada syndrome].

Author

Peyresblanques J, Saint Val C, and Collin JP

Subjects
Adult, Choroid blood supply, Cortisone administration & dosage, Electroretinography, Female, Fluorescein Angiography, Humans, Retinal Detachment etiology, Uveomeningoencephalitic Syndrome drug therapy, Uveitis diagnosis, Uveomeningoencephalitic Syndrome diagnosis
Published
1984

25. [Transfixing sclerociliary wounds. Apropos of 5 cases].

Author

Peyresblanques J, Boyer P, and Saint Val C

Subjects
Accidents, Traffic, Adult, Cryosurgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Sclera surgery, Vitrectomy, Ciliary Body injuries, Sclera injuries
Published
1984

26. [A familial case of botulism with severe toxemia].

Author

Peyresblanques J, Saint Val C, Duvezin-Caubet P, Brunel JP, Dussarte AM, Sire J, and Thibaut B

Subjects
Adult, Botulism blood, Botulism complications, Child, Child, Preschool, Female, Humans, Male, Toxemia, Botulism genetics, Diplopia etiology, Ophthalmoplegia etiology
Published
1978

27. [A case of Purtscher's syndrome; angiographic and therapeutic aspects].

Author

Peyresblanques J, Saint Val C, Poletto BB, Chenut JL, Dussarte AM, and Duvezin-Caubet P

Subjects
Adult, Cytidine Diphosphate Choline therapeutic use, Edema diagnosis, Edema drug therapy, Fluorescein Angiography, Humans, Male, Retinal Hemorrhage diagnosis, Retinal Hemorrhage drug therapy, Syndrome, Retinal Diseases diagnosis, Retinal Diseases drug therapy, Retinal Vessels injuries
Published
1978

28. [Electrophysiological exploration in glaucoma. Preliminary note].

Author

Peyresblanques J and Saint Val C

Subjects
Electroencephalography, Electroretinography, Evaluation Studies as Topic, Evoked Potentials, Humans, Photic Stimulation, Prognosis, Cerebral Cortex physiopathology, Glaucoma physiopathology, Retina physiopathology
Published
1977

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