identifying factors that affect adherence to prescribed treatments is the first step in improving adherence of patients with MS to therapy, thereby helping maximize the benefits of long-term DMTs.
Patients who had relapsing-remitting MS in the early stages of the disease and mild disability had significant callosal involvement that progressed over time. The relationship between disability, T2-weighted lesions load, and degree of morphological and functional callosal impairment confirm the potential value of using callosal dysfunction as a surrogate marker of disease progression in MS.
The interactions between alcohol and the CNS are complex and there are experimental data suggesting that chronic and acute effects are different and often opposite. An intriguing hypothesis is that repeated alcohol withdrawal seizures (AWS) may render the brain more excitable, leading to an epileptog-enic state reminiscent of the ‘kindling’ model. To gain insight into this question we compared alcoholic patients with seizures related to episodes of AW (AWS) and patients with seizures unrelated to episodes of AW (UAWS). There were several significant differences between the AWS and UAWS groups. Age at admission for seizure was younger in the AWS groups (p < 0.005), seizure number was higher among patients with a history of seizures before admission in the UAWS group (p < 0.05). Neurologic signs were more frequent in the UAWS group (p < 0.05). Duration of intoxication was longer in the UAWS group and brain atrophy demonstrated by CT scan was more common in the UAWS group than the AWS group. Based on these findings, we propose a dynamic classification in which patients presenting seizures unrelated to any cause other than alcohol are classified in several successive stages of ‘alcoholic epilepsy’, the first being characterized by AWS and the last by persistent chronic seizures.
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