| 1. |
- Boström, Inger, et al.
(författare)
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Does the changing sex ratio of multiple sclerosis give opportunities for intervention?
- 2015
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Ingår i: Acta Neurologica Scandinavica. - : Wiley. - 0001-6314 .- 1600-0404 .- 0065-1427 .- 1600-5449. ; 132, s. 42-45
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Forskningsöversikt (refereegranskat)abstract
- In several international studies, an increasing women-to-men (w/m) ratio in patients with multiple sclerosis (MS) has been reported. Such sex ratios have been analysed by year of onset or by year of birth. In a Swedish study, data from the Swedish MS register (SMSreg) were used to analyse the w/m ratio in Sweden. The sex ratio was analysed both by year of birth (8834 patients) and by year of onset (9098 patients). No increased w/m ratio was seen in this study. The age-specific sex ratio did not demonstrate any significant changes. However, a new investigation of the sex ratio in Sweden, based on data from all available data sources (19,510 patients), showed a significantly increased w/m ratio of MS in Sweden from 1.70 to 2.67. Environmental factors such as cigarette smoking, hormonal factors and nutrition are of interest in this context, but the cause of the increasing w/m ratio in MS is yet not possible to explain.
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| 2. |
- Pugliatti, M, et al.
(författare)
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A questionnaire for multinational case-control studies of environmental risk factors in multiple sclerosis (EnvIMS-Q)
- 2012
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Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell. - 0001-6314 .- 1600-0404 .- 0065-1427 .- 1600-5449. ; 126:SI, s. 43-50
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - The increasing incidence of multiple sclerosis (MS) worldwide, especially in women, points to the crucial role of environmental and lifestyle risk factors in determining the disease occurrence. An international multicentre case-control study of Environmental Risk Factors In Multiple Sclerosis (EnvIMS) has been launched in Norway, Sweden, Italy, Serbia and Canada, aimed to examine MS environmental risk factors in a large study population and disclose reciprocal interactions. To ensure equivalent methodology in detecting age-related past exposures in individuals with and without MS across the study sites, a new questionnaire (EnvIMS-Q) is presented. Materials and methods - EnvIMS-Q builds on previously developed guidelines for epidemiological studies in MS and is a 6-page self-administered postal questionnaire. Participants are de-identified through the use of a numerical code. Its content is identical for cases and controls including core and population-specific questions as proxies for vitamin D exposure (sun exposure, dietary habits and supplementation), childhood infections (including infectious mononucleosis) and cigarette smoking. Information on possible confounders or effect modifiers is also obtained. EnvIMS-Q was initially drafted in English and subsequently translated into Italian, Serbian, Norwegian, Swedish and French-Canadian. EnvIMS-Q has been tested for acceptability, feasibility and reliability. Results and Conclusions - EnvIMS-Q has shown cross-cultural feasibility, acceptability and reliability in both patients with MS and healthy subjects from all sites. EnvIMS-Q is an efficient tool to ensure proper assessment of age-specific exposure to environmental factors in large multinational population-based case-control studies of MS risk factors.
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| 3. |
- Caceres, R., et al.
(författare)
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Editorial: Application of a vagal nerve stimulator in an epilepsy patient with cardiac pacemaker after post-ictal cardiac arrest
- 2009
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Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell Publishing Inc.. - 0001-6314 .- 1600-0404. ; 120:2, s. 139-142
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In this case report we present a patient with temporal lobe epilepsy (TLE) showing partial complex seizures and secondary generalization, and treated with several antiepileptic drugs. After two consecutive seizures she had an episode of cardiac arrest followed by AV-block III which led to the implantation of a cardiac pacemaker. She subsequently received a vagal nerve stimulator because of poor response to epilepsy treatment. Combined treatment with two different electromagnetic stimulators raises the question of safety during surgery which is discussed.
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| 4. |
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| 5. |
- Callander, Margarita, 1964-, et al.
(författare)
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A cluster of multiple sclerosis cases in Lysvik in the Swedish county of Värmland
- 2004
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 110:1, s. 14-22
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Tidskriftsartikel (refereegranskat)abstract
- Objectives – When surveying the county of Värmland in Sweden in order to determine the prevalence of multiple sclerosis (MS), we observed an aggregation of MS cases originating from the parish of Lysvik in the local region called Fryksdalen. Our intention was to analyse this cluster thoroughly, confirming the MS diagnosis and seeing if a hereditary or environmental background was plausible.Methods – The medical files were studied and the cases were classified by a neurologist according to Poser's criteria. Hereditary factors were analysed.Results – Sixteen living cases of MS were found, either living in the parish (n = 6) or born or raised there and had later moved to another place (n = 10). All patients had clinically definite MS. Eleven patients had relatives with MS, all of these being descendants of the Suhoinen family. Another two cases were Suhoinen descendants who did not have relatives with MS. Other common ancestors were also identified. Two cases were adopted. Eleven deceased MS patients from Lysvik were found, 10 of them had Suhoinen ancestry.Conclusion – We report a cluster of MS cases with a common ancestry indicating heredity for MS in 85% of the cases. Lysvik is a parish where Finnish immigration was pronounced in the 17th century and there has been inbreeding to a certain extent through marriage between cousins. Thus, we interpret this aggregation as possibly being genetically based, and neurogenetic studies are now being performed. However, as two of the cases were adopted environmental factors must also be considered.
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| 6. |
- Landtblom, Anne-Marie, 1953-, et al.
(författare)
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A case of Kleine-Levin syndrome examined with SPECT and neuropsychological testing
- 2002
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 105:4, s. 318-321
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Tidskriftsartikel (refereegranskat)abstract
- A case of Kleine-Levin syndrome with typical periodic hypersomnia and bulemia was diagnosed. On examination with single photo emission tomography (SPECT) (CERETEC«) during a relapse period and 2 weeks later there was marked cortical hypoperfusion of the frontal and temporal lobes, especially on the left side as well as in the right parietal lobe. Neuropsychological testing performed 1 week after a relapse showed a reduction in encoding to memory function of verbal learning indicating neocortical damage of the left fronto-temporal region. A follow-up 2 months later after the patient had spontaneously recovered showed only a slight left fronto-temporal disturbance. CT and MRI of the brain were normal although the MRI showed a large and asymmetric mamillary body. Neuropsychological testing 6 years after recovery showed pronounced reduction in short-time verbal and visual memory. Seven years after recovery SPECT demonstrated a normalized frontal perfusion but still a slight hypoperfusion in the left temporal lobe. Our results correlate to autopsy findings in two cases described previously.
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| 7. |
- Landtblom, Anne-Marie, 1953-, et al.
(författare)
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Further considerations on the distribution of multiple sclerosis in Sweden
- 2005
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 111:4, s. 238-246
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - The geographic distribution of multiple sclerosis (MS) in Sweden over time was compared in order to analyze homogeneity. Methods - The distribution of MS was compared among three nationwide resources: 1301 hospital cases 1925-1934, 5425 deaths 1952-1992, and 11,371 disability pension recipients 1971-1994. Results - Distributions by county (län) were markedly non-homogenous, with greatest variations in the early prevalence series (16-232% of the national mean), less within the death data (75-170%), and least for the disability series (87-128%). Maximal rates for MS in the early prevalence series were found for the cluster of seven counties surrounding the two major lakes of south central Sweden, as well as for one region on the northern shore of the Bay of Bothnia, and another also off the Bay north of Stockholm. Conclusion - Though the epidemiologic sources are quite different, they are internally consistent and thus provide three consecutive cross-sectional views of the distribution over time. When considered together the data may be compatible with a thesis of the origin and spread of MS within Sweden from the south-central inland lake regions of the country. Such spread within a half century is too rapid for a genetic cause, including HLA patterns. Copyright © Blackwell Munksgaard 2005.
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| 8. |
- Landtblom, Anne-Marie, 1953-, et al.
(författare)
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Short-term memory dysfunction in Kleine-Levin syndrome
- 2003
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 108:5, s. 363-367
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Tidskriftsartikel (refereegranskat)abstract
- Background - A previous investigation at our department of a young man with typical Kleine-Levin syndrome revealed short-term memory dysfunction as well as hypoperfusion of the temporal lobes on single photon emission tomography (SPECT) (CERETECR) examination, 6 and 7 years after recovery, suggesting long lasting or even permanent cerebral dysfunction. Patients and methods - We investigated four cases with classical adolescent Kleine-Levin syndrome characterized by hypersomnia and typical associated symptoms. We used neuropsychological testing and SPECT (CERETECR) of the brain. The results from the previous report related to above is included. Results - Examination with SPECT (CERETECR) during remission revealed hypoperfusion of the temporal lobes and fronto-temporal region in two of four cases. There were normal findings in two. Neuropsychological testing performed during remission showed reduction in the short-term memory capacity in all four cases. Conclusion - It is striking that all the cases investigated showed short-term memory dysfunction. One patient who had recovered from paroxysmal symptoms (hypersomnia attacks and bulimia) 6 years earlier showed progress in the short-term memory dysfunction. A pathologic condition in the temporal lobes may be suspected in Kleine-Levin syndrome.
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| 9. |
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| 10. |
- Fridriksson, Steen, 1961-, et al.
(författare)
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Education of referring doctors about sudden onset headache in subarachnoid hemorrhage
- 2001
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 103:4, s. 238-242
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Tidskriftsartikel (refereegranskat)abstract
- Objectives – Forty percent of patients with aneurysmal subarachnoid hemorrhage have prodromal warning episodes and difficulties in identifying these events are repeatedly documented. Modifications of diagnostic and referral patterns through educational programs of local doctors may help to identify such patients before a major devastating rupture occurs.Materials and methods– A teaching program about sudden onset headache, targeting referring doctors, was systematically applied and its impact on early misdiagnosis of ruptured aneurysms was prospectively studied.Results– Forty percent of all studied patients experienced a warning episode, manifested as apoplectic headache, prior to hospitalization. An initial diagnostic error was evident in 12% of the patients. Diagnostic errors were reduced by 77% as a result of continuous interaction between neurosurgeons and local physicians.Conclusion– Misdiagnosed warning episodes cause greater loss of lives and higher morbidity on a population basis than does delayed ischemic complications from vasospasm in aneurysmal SAH. Teaching programs focused on local physicians have a profound impact on outcome at low cost.
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