Latest MS research update - 16 July 2010
The MS Trust runs a weekly search for interesting and relevant research articles relating to multiple sclerosis using Medline, a specialised search engine for medical journals. The following updates consist of a selection of articles retrieved through the Medline search in recent weeks. The original abstracts to each of the articles can be accessed via the Medline links provided.
- People with MS more likely to suffer from migraines
- Plasma exchange treats relapses that don't respond to steroids
People with MS more likely to suffer from migraines
Previous research has suggested that people with MS are more likely to suffer with headaches than the general population. This study investigated the frequency of migraine in the MS population and any potential links between other MS symptoms and migraine.
The data for 204 people with MS was compared against data that had been collated on the frequency of migraine in the general population. The comparison of data revealed that people with MS were three times more likely to experience migraine than people without MS.
The symptoms that were more commonly seen in people with MS who experienced migraine included trigeminal and occipital neuralgia (a distinct type of headache characterised by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head), facial pain, L'hermitte's sign, muscle pain, non-headache pain and a past history of depression. The frequency of migraine did not appear to be associated with level of disability or disease activity as seen on MRI.
Kister I, Caminero AB, Monteith TS, et al.
Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course.
The Journal of Headache and Pain 2010; Epub ahead of print.
Medline abstract
Plasma exchange treats relapses that don't respond to steroids
MS relapses are often treated with steroids. Studies have shown that steroids are effective in speeding up recovery from an MS relapse. However, not all people respond to steroids and depending on the severity of the relapse, a doctor may recommend plasma exchange if steroids have not proven effective. Plasma exchange involves the removal and replacement of the liquid part of the blood (called plasma). Relatively few studies have demonstrated the effectiveness of this treatment for MS relapses.
This paper presents a small series of cases of people with an aggressive course of relapsing remitting MS whose steroid unresponsive relapses were treated with plasma exchange.
Four people with MS with steroid unresponsive relapses were treated with methylprednisolone, either with 500mg for five days or 1000mg for three days. If no improvement was seen within this time people were given five cycles of plasma exchange. If no improvement was seen after the initial five cycles, then a further five were administered.
For four relapses, five cycles of plasma exchange were given with marked recovery in one case, moderate recovery in two cases, and mild recovery in one case. In one person, after five initial cycles there was no recovery but after five further cycles there was moderate recovery.
The authors suggest that these cases support the use of plasma exchange in the treatment of steroid unresponsive relapses in aggressive relapsing remitting MS.
Habek M, Barun B, Puertic Z, et al.
Treatment of steroid unresponsive relapse with plasma exchange in aggressive multiple sclerosis.
Therapeutic Apheresis and Dialysis 2010; 14(3):298-302.
Medline abstract
