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The safety of Ramadan fasting for Muslim patients suffering from multiple sclerosis (MS) is still a matter of debate. This work aimed to study the clinical course of MS during Ramadan fasting and to clarify the predictors of relapses and symptoms exacerbation. This retrospective study included 153 Muslim patients with MS. Data related to the disease course before Ramadan were obtained from patients' files, whereas data related to the disease activity during Ramadan, were collected from patients over the two months following Ramadan. Patients with MS who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant longer disease duration compared to those who did not experience (P < 0.001, <0.001, 0.01 respectively). Also, patients who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant higher expanded disability status scale (EDSS) compared to those who did not experience (P <0.001, <0.001,0.01, respectively). The occurrence of relapses, exacerbation of symptoms and development of new symptoms during Ramadan, were significantly higher in patients who experienced relapses in the preceding year compared to those who did not (P= 0.002, 0.002, 0.01, respectively). Binary logistic regression revealed that each score elevation of EDSS increased the odds of relapse during Ramadan by 1.02 (P-value = 0.04). Also, each month's increase in disease duration increased the odds of relapse during Ramadan by 1.87 (P-value = 0.046). High EDSS and long disease duration are independent predictors of relapse during Ramadan. [ABSTRACT FROM AUTHOR]

Background: Grey matter involvement is suggested to have a role in pathophysiology of multiple sclerosis (MS). Objective: Our aim is to detect the thalamic involvement using 1.5 Tesla Diffusion tensor imaging (DTI) and its relationship with cognitive impairment, clinical disability and fatigue in MS patients. Methods: 31 patients with MS (23 RRMS and 8 SPMS) with mean age 34.4±8.5 SD were studied. We recruited also 18 age, sex and education level matched healthy controls. They all underwent clinical assessment, cognitive assessment using California verbal learning test, brief visuospatial memory test, paced auditory serial addition task (PASAT), symbol digit modalities test, controlled oral word association test, assessment of fatigue using fatigue severity scale, and radiological assessment using 1.5 T DTI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured over regions of interest over the thalamus. Results: Patients with MS had higher thalamic FA (P<0.01) and ADC (P<0.01) than controls. Patients showed significantly worse performance in all cognitive tests than controls. There was significant correlation between total EDSS and mean thalamic FA. In addition, there were good positive correlations between disease duration, number of attacks and mean FA over the thalamus. There were significant correlations between performance in neuropsychological tests, disease duration, number of attacks and total EDSS. Conclusion: DTI was able to detect abnormalities in normal-appearing thalamus of patients with MS. Thalamic involvement had significant relations with cognitive impairment and clinical disability in patients with MS. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, which shows heterogeneity in its various clinical and pathological patterns. A number of inflammatory conditions may mimic MS which makes definite diagnosis of MS sometimes challenging. The Kasr Al-Ainy MS unit "KAMSU", Cairo University, out of the believe that each patient with MS should receive a standard medical care according to the available logistics, proposed a special protocol that can meet the needs for the Egyptian MS patients whatever their financial status is. To proceed with the process of developing this protocol, the KAMSU team has been formed and assigned into subgroups each handling a specific topic, and an extensive Medline search has been carried out to gather related data from reliable sources. [ABSTRACT FROM AUTHOR]

Background: Chronic cerebrospinal venous insufficiency (CCSVI) has been reported with multiple sclerosis (MS). However, its actual prevalence, possible association with specific MS parameters and potential pathophysiological role are debated. Objective: To study the role of CCSVI in multiple sclerosis, to detect if there is relation between CCSVI and clinical characteristics of disease or with the load of MRI lesions. Methods: This study was conducted on 15 Egyptian MS patients and 15 age and sex matched healthy control subjects. Patients were subjected to clinical evaluation (history& examination); severity was assessed by Expanded Disability Status Scale (EDSS). Magnetic resonance imaging of brain and Magnetic resonance venography (MRV) for detection of venous abnormalities were done to all study members. Results: CCSVI was found in 40% of multiple sclerosis patients compared to healthy controls (6.7% of healthy control). No statistically significant difference was found between CCSVI positive and negative patients regarding the age of the patients, the gender, the age at the disease onset, the duration and severity of the disease, the type of multiple sclerosis, the degree of disability or the load of MRI brain lesions. Conclusion: There is a high prevalence of CCSVI among multiple sclerosis patients. CCSVI is not related to clinical characteristic of the disease or to MRI load. It is not yet established whether CCSVI is in the causal pathway of MS, or there is a possible indirect association between CCSVI and MS. [ABSTRACT FROM AUTHOR]

Background: Executive dysfunction in multiple sclerosis varies in relation to the course of the disease and therapy and could be correlated with 3- tesla MRI. Objective: Compare aspects of executive dysfunction and memory in RRMS and SPMS and interferon and non interferon treated patients correlating findings with 3 -tesla MRI brain images. Methods: Thirty MS patients were included [25 RRMS and 5SPMS] 16 of them receive interferon were subjected to neurological, EDSS, fatigue severity scale, Beck depression Inventory assessment. In addition, neuropsychological assessment of memory, learning and executive dysfunctions. A 3- tesla MRI brain imaging within 48 hours of the assessment. Ten healthy age, sex and educational level matched controls were selected for comparison of the psychometric results. Results: Patients with RRMS showed no significant change in memory tests while those with SPMS showed significant worse performance in the executive functions test .Patients on interferon therapy showed preserved good performance in verbal and visuospatial learning when compared with the non treated patients. The corpus callosum thickness was significantly correlated with processing speed, verbal learning and verbal fluency. The brain parenchyma was significantly correlated with ability to display flexibility in the face of changing schedules. The 3rd ventricle width was significantly negatively correlated with visuospatial learning. Conclusion: Patients with MS exhibit different patterns of affection of their executive functions and memory in different courses of the disease. Treatment with interferon was associated with preserved abilities in specific aspects of executive dysfunctions. [ABSTRACT FROM AUTHOR]