Multiple Sclerosis and CNS Inflammatory Disorders -- Copyright -- Contents -- Contributors -- Series Foreword -- Preface -- 1 Etiology -- Background -- Genes -- Gender effects: Genetic or biologic? -- The role of the environment -- Environmental MS risk factors: The major players -- Vitamin D -- Infection -- Smoking -- Combining risk factors -- Conclusion -- Acknowledgment -- References -- 2 Immunopathogenesis of Multiple Sclerosis -- What does the neuropathology of MS tell us about its pathogenesis? -- Gray matter pathology -- Multiple sclerosis as an autoimmune disease -- Candidates for the self-antigen in multiple sclerosis -- Antigen spreading -- Epitope spreading -- Outside-in versus inside-out ? -- Lymphocyte trafficking into the CNS -- Role of T cells in MS -- Role of B cells and humoral immunity -- Role of microglia and macrophages -- Role of other cells: Dendritic cells and astrocytes -- Role of cytokines -- What might trigger autoimmunity? -- Further Reading -- 3 Diagnostic Process -- Introduction -- Clinical features of MS -- Defining MS -- MS disease courses -- Common symptoms in MS -- Diagnostic evaluation of MS -- MRI -- Revised McDonald criteria for diagnosis of  MS -- Ancillary testing in the diagnosis of MS -- Differential diagnosis of MS -- Conclusion -- Further Reading -- 4 MRI in Diagnosis and Disease Monitoring -- Introduction -- MRI at presentation -- Lesions -- Brain atrophy -- Spinal cord -- MRI diagnostic criteria -- MRI consensus protocol -- MRI for monitoring disease and treatment -- New lesion activity -- Brain atrophy -- Limitations -- Nonconventional MRI -- Magnetization transfer imaging -- Magnetic resonance spectroscopy -- Susceptibility-weighted imaging -- Diffusion-weighted imaging -- Perfusion-weighted imaging -- Conclusions -- Acknowledgments -- References.

5 Relapsing MS: Disease Staging and Therapeutic Algorithms -- Introduction -- Window -- Prognostic factors -- Therapy -- Initiation -- Early window -- Late window -- Suboptimal response -- Intolerance: Lateral therapy -- Mild breakthrough: Lateral therapy -- Major breakthrough -- Combination therapy -- Rescue therapy -- Escalation -- Rapid advancement -- Conclusion -- Newer oral agents -- Further Reading -- 6 Progressive MS Treatment Algorithms -- Background -- Challenges to clinical trials in progressive MS -- Clinical trials in progressive MS -- Interferon-beta -- Glatiramer acetate -- Mitoxantrone -- Cyclophosphamide -- Methotrexate -- Methylprednisolone -- Other disease-modifying therapies -- Monitoring progressive MS in clinical practice -- Treatment of progressive MS in clinical practice -- Stopping disease-modifying therapy -- Neuroprotective strategies -- Other treatment considerations -- Further Reading -- 7 Sex-Determined Issues in Multiple Sclerosis -- Epidemiology of MS and gender -- Basic science of sex hormone and chromosome differences seen in MS -- Actions of sex hormones -- Gender effects seen in genetics of MS -- Reproductive issues in MS -- Menstrual cycle and menopause -- Effects on fertility -- Contraceptive issues -- Congenital effects -- Pregnancy and the MS patient -- Epidemiology -- Clinical concerns -- Management of pregnant patient: Before, during, and after -- Breastfeeding -- Female cancers -- Male sex hormones and concerns for the male patient -- Acknowledgments -- References -- 8 Pediatric Multiple Sclerosis -- Introduction -- Definitions -- ADEM, and multiphasic  ADEM -- Clinically isolated syndromes (CIS) -- Pediatric multiple sclerosis -- Clinical outcome following a first demyelinating attack -- Epidemiology and risk factors -- Clinical presentation -- Disease course -- Diagnostic considerations -- MRI.

Spinal fluid -- Evoked potentials -- Differential diagnosis -- Treatment of acute demyelinating attacks -- Disease-modifying therapy -- Interferon-beta -- Glatiramer acetate -- Escalation of care for severe MS -- Natalizumab -- Other agents -- Symptomatic therapy -- Cognitive dysfunction and quality of life considerations -- Conclusions and future directions -- Further Reading -- 9 Complementary and Alternative Medicine: Risks and Benefits -- Introduction -- Terminology -- Unconventional medicine use -- CAM therapies -- Antioxidants -- Bee venom therapy -- Cooling therapy -- Cranberry -- Diets: The Swank diet and related diets -- Echinacea and other immune-stimulating supplements -- Ginkgo biloba -- Guided imagery -- Low-dose naltrexone (LDN) -- Marijuana (cannabis) -- Massage -- Reflexology -- Tai chi -- Vitamin B12 -- Vitamin D -- Yoga -- Conclusion -- Further Reading -- 10 Symptomatic Management of MS -- Bladder dysfunction -- Bowel dysfunction -- Sexual dysfunction -- Pain -- Paroxysmal pain -- Constant pain -- Impaired gait -- Spasticity -- Tremor -- Further Reading -- 11 Invisible Symptoms of MS: Fatigue, Depression, and Cognition -- Introduction -- Fatigue -- Assessment -- Pathogenesis -- Management -- Cognition -- Assessment -- Pathogenesis -- Treatment -- Depression -- Assessment -- Pathogenesis -- Treatment -- Summary -- Reference -- Further Reading -- 12 Rehabilitation -- Introduction -- Physical rehabilitation -- Ambulation: Principles and perturbations -- Improving ambulation -- Upper extremity function -- Home modifications -- Organ rehabilitation: Bladder and bowel management -- Cognitive rehabilitation -- Challenges in diagnosis -- The case for nonpharmacological treatment -- Summary -- References -- 13 Psychosocial Adaptation to Multiple Sclerosis -- Introduction -- Coping and adaptation -- Stages and phases in the adaptation process.

Prediagnosis phases -- The crisis phase -- The interim/transitional phase -- Chronic phase -- The accommodation phase -- Acknowledgments -- References -- 14 Transverse Myelitis and Acute Disseminated Encephalomyelitis -- Introduction -- Transverse myelitis -- Epidemiology -- Pathobiology -- Clinical presentation -- Differential diagnosis and diagnostic criteria -- Acute treatment -- Outcomes and long-term management -- Acute disseminated encephalomyelitis (ADEM) -- Epidemiology -- Pathobiology -- Clinical presentation -- Differential diagnosis and diagnostic criteria -- Acute treatment -- Outcomes and long-term management -- References -- 15 Neuromyelitis Optica -- Introduction -- Diagnosis -- Demographic features -- Clinical characteristics -- Diagnostic criteria -- Investigations -- Differential diagnosis -- Treatment -- Acute treatment -- Long-term treatment -- Future treatment perspectives -- Prognosis and follow-up -- Measuring disability -- Antibody serology and titers -- 16 Neurosarcoidosis -- Introduction -- General principles of diagnosis -- General principles of treatment -- Dosages -- Specific presentations -- Aseptic meningitis -- Myelopathy -- Cerebral neurosarcoidosis -- Cranial neuropathy -- Peripheral neuropathy and myopathy -- Prognosis and long-term monitoring -- Further Reading -- 17 Lyme Neuroborreliosis -- Introduction -- Borrelia burgdorferi infection -- Nonneurologic manifestations -- Early neurologic manifestations -- Later-onset neurologic manifestations -- Diagnosis -- Differential diagnosis -- Treatment -- Conclusion -- Acknowledgments -- References -- Further Reading -- 18 Neuro-Behçet Syndrome -- Introduction -- Epidemiology -- Diagnosis and systemic manifestations of Behçet disease -- Oral aphthae -- Genital ulceration -- Skin lesions -- Eye involvement -- The pathergy phenomenon -- Musculoskeletal involvement.

Gastrointestinal involvement -- Cardiovascular involvement -- Other systems -- Laboratory investigations -- Pathology and etiopathogenesis of Behçet syndrome -- Nervous system involvement in Behçet disease: Neuro-Behçet syndrome -- Extra-axial NBS -- Intra-axial NBS -- Arterial NBS -- Neuro-psycho-Behçet syndrome -- Cognitive changes in BD -- Headache in BS -- PNS involvement -- Subclinical NBS -- Diagnostic studies in NBS -- Neuroimaging -- CSF -- Differential diagnosis -- Prognosis -- Treatment -- Intra-axial NBS -- Extra-axial NBS -- References -- Index.