Guidance for the preparation of neurological management guidelines by EFNS scientific task forces – revised recommendations 2004*

Brainin, Michael; Barnes, Michael P.; Baron, Jean‐Claude; Ne, Gilhus; Hughes, Richard A.; Selmaj, Krzysztof; Waldemar, Gunhild

doi:10.1111/j.1468-1331.2004.00867.x

Cited by 369 publications

(243 citation statements)

References 15 publications

(16 reference statements)

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“…The classification for evidence levels for therapeutic interventions was made according to the guidance for the preparation of neurological management guidelines by EFNS scientific task forces [11].…”

Section: Methodsmentioning

confidence: 99%

EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients

Einhäupl

Stam

Bousser

et al. 2010

Euro J of Neurology

443

343

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Background: Cerebral venous and sinus thrombosis (CVST) is a rather rare disease which accounts for <1% of all strokes. Diagnosis is still frequently overlooked or delayed as a result of the wide spectrum of clinical symptoms and the often subacute or lingering onset. Current therapeutic measures which are used in clinical practice include the use of anticoagulants such as dose-adjusted intravenous heparin or body weight-adjusted subcutaneous low-molecular-weight heparin (LMWH), the use of thrombolysis and symptomatic therapy including control of seizures and elevated intracranial pressure. Methods: We searched MEDLINE (National Library of Medicine), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Library to review the strength of evidence to support these interventions and the preparation of recommendations on the therapy of CVST based on the best available evidence. Review articles and book chapters were also included. Recommendations were reached by consensus. Where there was a lack of evidence but consensus was clear we stated our opinion as good practice points. Results and conclusions: Patients with CVST without contraindications for anticoagulation (AC) should be treated either with body weight-adjusted subcutaneous LMWH or with dose-adjusted intravenous heparin (level B recommendation). Concomitant intracranial haemorrhage (ICH) related to CVST is not a contraindication for heparin therapy. The optimal duration of oral anticoagulant therapy after the acute phase is unclear. Oral AC may be given for 3 months if CVST was secondary to a transient risk factor, for 6-12 months in patients with idiopathic CVST and in those with ''mild'' thrombophilia, such as heterozygous factor V Leiden or prothrombin G20210A mutation and high plasma levels of factor VIII. Indefinite AC should be considered in patients with recurrent episodes of CVST and in those with one episode of CVST and ÔsevereÕ thrombophilia, such as antithrombin, protein C or protein S deficiency, homozygous factor V Leiden or prothrombin G20210A mutation, antiphospholipid antibodies and combined abnormalities (good practice point). There is insufficient evidence to support the use of either systemic or local thrombolysis in patients with CVST. If patients deteriorate despite adequate AC and other causes of deterioration have been ruled out, thrombolysis may be a therapeutic option in selected cases, possibly in those without large ICH and threatening herniation (good practice point). There are no controlled data about the risks and benefits of certain therapeutic measures to reduce an elevated intracranial pressure (with brain displacement) in patients with severe CVST. However, in severe cases with impending herniation craniectomy can be used as a life-saving intervention (good practice point).Background and objectives

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Section: Methodsmentioning

confidence: 99%

EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients

Einhäupl

Stam

Bousser

et al. 2010

Euro J of Neurology

443

343

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“…12 Due to the universal scope of this review, local issues such as costs and drug licensing were not taken into account when offering advice on use in clinical practice. Two independent investigators (SO and JS) evaluated the quality of evidence and wrote the initial draft that was evaluated by the chairman (XM) and circulated to the rest of the authors for further input, discussion and final agreement.…”

Section: Methods (Search Strategy and Consensus)mentioning

confidence: 99%

Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper

et al. 2016

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“…Randomized, controlled studies were considered to have the highest level of evidence, followed by one or more well documented clinical studies, such as casecontrolled or cohort studies, and the lowest level of evidence was assigned to nonrandomized historical controls, case reports, or expert opinions. Levels of evidence were defined according to the standards of the European Federation of Neurology [Brainin et al 2004]. …”

Section: Methodsmentioning

confidence: 99%

Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity

Leussink

Husseini

Warnke

et al. 2012

Ther Adv Neurol Disord

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A large proportion of patients with multiple sclerosis (MS) have spasticity, which has a marked impact on their quality of life. Anecdotal evidence suggests a beneficial effect of cannabis on spasticity as well as pain. Recently, randomized, double-blind, placebocontrolled studies have confirmed the clinical efficacy of cannabinoids for the treatment of spasticity in patients with MS. Based on these data, nabiximols (Sativex), a 1:1 mix of ∆-9-tetrahydrocannabinol and cannabidiol extracted from cloned Cannabis sativa chemovars, received approval for treating MS-related spasticity in various countries around the globe. In this article we review the current understanding of cannabinoid biology and the value of cannabinoids as a symptomatic treatment option addressing spasticity in patients with MS.

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Guidance for the preparation of neurological management guidelines by EFNS scientific task forces – revised recommendations 2004*

Cited by 369 publications

References 15 publications

EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients

EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients

Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper

Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity

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