Sexual Dysfunction In Men With Multiple Sclerosis
A Comprehensive Pilot-Study Into Etiology
Lottman PE, Jongen PJ, Rosier PF, Meuleman EJ
Ideally, the etiological diagnosis of Sexual Dysfunction in patients with Multiple Sclerosis is established on the basis of both objective and subjective tests.
Int J Impot Res 1998 Dec;10(4):233-7
Univ Hospital Nijmegen, Dept of Urology, The Netherlands
UI # 99100657
Accordingly, we assessed sexual function in 16 male patients with Multiple Sclerosis and complaints of Sexual Dysfunction by means of subjective data from interviews and questionnaires and objective data, obtained from PsychoPhysiological tests.
PsychoPhysiological investigation consisted of measurement of sleep erections and of Erectile response to visual erotic stimulation and penile vibration. Urodynamic investigation was used to assess the Neurological status of the Genital Tract.
Sixteen male patients with clinically definite Multiple Sclerosis, complaints of Sexual Dysfunction and a steady heterosexual relationship participated in the study.
The majority of patients had no abnormalities in the objective tests. Only one (1 out of 15) patient showed disturbed sleep-erections, and four (4 out of 12) other patients showed signs of Neurological Dysfunction of the Genital Tract.
In our patient-group, disturbed sleep erections and abnormal findings on Urodynamic investigation appeared unrelated to the complaint of Erectile Dysfunction. Sexual Function was related to Psychological factors, Decreased General Sensitivity, and Motor Impairment.
The Influence of Oral Contraceptives On
The Risk Of Multiple Sclerosis
Thorogood M, Hannaford PC
Br J Obstet Gynaecol 1998 Dec;105(12):1296-9
London School of Hygiene and Tropical Medicine, Dept of Public Health and Policy, UK
UI # 99098390
To examine the risk of Multiple Sclerosis in users of combined oral contraceptives.
Design & Setting
Cohort study conducted between 1968 and 1996 using diagnostic data supplied by general practitioners. General practices throughout the United Kingdom.
Royal College of General Practitioners' Oral Contraception Study cohort of initially 46,000 women recruited during the late 1960s.
Directly standardized incidence rates of Multiple Sclerosis were calculated for current, former and never-users of oral contraceptives using first ever cases of Multiple Sclerosis reported by the general practitioners.
The standardisation variables were age, parity, social class and smoking history. Five-year survival rates in the different contraceptive groups were calculated using standard life table techniques.
One hundred and fourteen first ever cases of Multiple Sclerosis had been reported by November 1996 during 564,000 woman-years of observation. The incidence rate in both current and former users was not materially different to that in never-users.
Although based on limited evidence there was no suggestion that the five-year survival was affected by a woman's use of combined oral contraceptives.
These findings do not suggest a greatly elevated risk of Multiple Sclerosis during, or after, use of combined oral contraceptives.
Control Cognitions & Psychological Disturbance In Contrasting Physically Disabling Conditions
Macleod L, Macleod G
Disabil Rehabil 1998 Dec;20(12):448-56
Lanarkshire Health Care NHS Trust, Hamilton and East Kilbride Child and Family Clinic, Scotland
UI # 99099847
This study examines the role of control Cognitions, i.e. locus of control (LOC), in predicting adaptation to two contrasting physically disabling conditions.
Locus of control beliefs were investigated in terms of their relationship with Psychological Distress (Anxiety and Depression) experienced by people facing either Spinal Cord Injury (SCI) or Multiple Sclerosis (MS). The role of pain experience was also considered in terms of its impact on Psychological Distress in both groups.
Results indicated that although SCI subjects were more internally oriented than MS subjects, internality was not linked to lower levels of Depression or Anxiety in either group, although within the SCI group an external LOC was associated with increased Depression and physical disability.
For people facing a future with the challenge of physical disability, the pattern of progression of disability over time may be of significance in the development of Psychological Distress.
Neck Pain: Epidemiology, Physical Examination, and NeuroDiagnostics
The overall frequency of troublesome neck pain is estimated to be approximately 34%, and it was observed that the frequency of complaints lasting 1 month or longer was higher in women than in men.
Spine 1998 Dec 15;23(24):2663-73
Schulthess Clinic, Dept of Neurology, Zurich, Switzerland
UI # 99095143
The prevalence increased with age with regard to both pain duration and chronic pain. A total of approximately 14% of a randomly selected population meets the criteria for chronic neck pain, with complaints lasting for more than 6 months.
It could be that the structural transformation of the InterVertebral disc, the uncovertebral processes, and the zygapophyseal joints is a process accompanied by disturbed function, ultimately inducing pain. For diagnosis of Radicular and Myelopathic Syndromes, the physical and Neurologic Examination is enhanced by NeuroPhysiologic Assessment.
ElectroMyography, performed with needle electrodes, is the oldest method to diagnose Nerve Root Compression Syndromes and is claimed to have no false positive results.
ElectroMyography for Radiculopathy is justified if clinical symptoms, such as muscular weakness, don't correlate with clinical findings (diminished or absent reflex), or for documentation of muscle activity if difficult decompressive surgery is expected.
For diagnosis of Cervical Myelopathy by routine examination, the Sensory Evoked Potentials by stimulation of tibial nerve as well as Motor Evoked Potentials from upper and lower extremities are recommended because clinically "silent" Myelopathy can be verified by abnormalities in Evoked Potentials.
During history taking, the symptoms possibly attributed to Radiculopathy or Myelopathy should be differentiated from Primary Systemic Neurologic Disorders such as Shoulder Angiotrophy ("Plexus Neuritis"), Multiple Sclerosis, Amyotrophic Laterals Sclerosis, and Peripheral Neuropathy.
The assessment of range of motion, the functional status of shoulder and neck muscles, and palpatory examination of soft tissue is widely used to determine non-operative therapeutic procedures. However, scientifically, the validity of the different testing procedures has not been evaluated satisfactorily.
Suppression of Experimental AutoImmune EncephaloMyelitis by Tyrphostin AG-556
Brenner T, Poradosu E, Soffer D, Sicsic C, Gazit A, Levitzki A
Induction bioassay to measure Neutralizing AntiBodies to Interferon-beta1b (IFN-ß-1b, the active ingredient in Betaseron) in Sera from patients treated with Betaseron. This AntiBody assay has been validated to quantify Neutralizing titers of 1:20 and above, with a precision of +/- 0.20 in log10.
Exp Neurol 1998 Dec;154(2):489-498
Hadassah Univ Hospital, Dept of Neurology, Jerusalem, 91120
UI # 99093272
We have used this MxA gene-induction AntiBody assay to reinvestigate Serum samples from Multiple Sclerosis (MS) patients treated with Betaseron. The titers measured were closely comparable to those obtained in AntiViral assays.
Data obtained by both methods show that Neutralizing AntiBodies may appear and subsequently disappear over time in the Sera of some patients treated with Betaseron. Sera from some patients contain Binding AntiBodies to IFN-ß-1b.
It was shown that Binding AntiBody titers do not correlate quantitatively or qualitatively with Neutralizing Antibody titers, and indeed, a number of patients develop high levels of Binding AntiBodies but never form measurable levels of Neutralizing AntiBodies.
MRI of Optic Nerve and PostChiasmal Visual Pathways and Visual Evoked Potentials in Secondary/Progressive Multiple Sclerosis
Davies MB, Williams R, Haq N, Pelosi L, Hawkins CP
We studied the relationship between abnormalities shown by MRI and functional disturbances in the Visual Pathway as assessed by the Visual Evoked Potentials (VEP) in 25 patients with established Multiple Sclerosis (MS); only 4 of whom had a history of acute Optic Neuritis.
NeuroRadiology 1998 Dec;40(12):765-70
Keele University, School of Postgraduate Medicine, Dept of Neurology and NeuroPhysiology,
North Staffordshire Hospital, Stoke-on-Trent, England
UI # 99092955
Optic Nerve MRI was abnormal in 19 (76%) and is thus useful in detecting subclinical disease. Optic Nerve total lesion length and area on the STIR sequence was found to correlate significantly with prolongation of the VEP latency.
This may reflect a predominantly DeMyelinating rather than Inflammatory origin for the signal change in the Optic Nerve.