Dermatologic findings after initiation of fingolimod in patients with multiple sclerosis: A real-world experience of five-year follow-up.

Background: Fingolimod was approved in 2010 for the treatment of relapsing-remitting multiple sclerosis, generally as second-line therapy. While its efficacy in reducing the relapse rate is well-recognized, the dermatologic complications of fingolimod remain unexplored. Herein, we aimed to report our experience with multiple sclerosis patients treated with fingolimod who underwent periodic dermatologic examinations.

Atypical Multiple Sclerosis Overlapping Features of Neuromyelitis Optica Spectrum Disorders (NMOSD).

We aim to discuss the importance of accurately diagnosing atypical inflammatory demyelinating diseases (IDD), particularly neuromyelitis optica spectrum disorders (NMOSD), which exhibit similar pathological characteristics to multiple sclerosis (MS). An accurate diagnosis is crucial as the disease-modifying treatments (DMTs) used for MS can be ineffective or even exacerbate NMOSD. Our case was a 20-year-old man who presented with acute quadriparesis and hyperreflexia.

Is it time to consider the live attenuated varicella-zoster virus (VZV) vaccination safe in patients with multiple sclerosis treated with natalizumab? An extension study of the first Iranian experience.

Introduction: Vaccination with live attenuated vaccines is generally not recommended in patients with MS (PwMS) treated with natalizumab. However, there are new insights to reconsider vaccination practice in PwMS. The present study aimed to report the results of live-attenuated varicella-zoster virus (VZV) vaccination in PwMS while receiving natalizumab.

Investigating treatment alternatives for fingolimod in patients with multiple sclerosis developed refractory fingolimod-related genital Human Papilloma Virus (HPV) infection.

Introduction: Genital human papillomavirus (HPV) infection is a rare skin complication in patients with relapse-remitting multiples sclerosis (RRMS) treated with fingolimod. Herein, we aimed to report a case series of 23 MS patients who had to discontinue fingolimod due to persistent HPV infection.

Materials And Methods: This retrospective case series was conducted between September 2023 to September 2024 in six MS centers in Iran to identify the outcome of HPV infection who discontinued fingolimod.

De-escalation of anti-CD20 monoclonal antibodies to low-moderate efficacy disease-modifying treatments (DMTs) in patients with relapse-remitting multiple sclerosis: An initial Iranian experience.

Background: Anti-CD20 are among the high-efficacy DMTs commonly used in treating multiple sclerosis (MS). Long-term safety data on anti-CD20s are limited. There is convincing evidence of hypogammaglobulinemia in the long-term use of anti-CD20s, raising the likelihood of infection.

A pregnant woman with amyotrophic lateral sclerosis from Iran: a case report.

Introduction And Importance: Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease, which is extremely rare during pregnancy. The severity of the disease affects the pregnancy outcome. The present study reports the first Iranian case of a woman with ALS overlapping pregnancy.

Dalfampridine in the treatment of primary fatigue in patients with multiple sclerosis: a randomized clinical trail.

Introduction: Fatigue is a highly prevalent debilitating symptom among patients with multiple sclerosis (PwMS), which markedly affects the quality of life. The present study aimed to evaluate the effect of extended-release fampridine on fatigue in PwMS.

Methods: This was a randomized, double-blind clinical trial on 77 PwMS with a complaint of fatigue, aged over 18 years old, randomized to extended-release fampridine (n = 44) or placebo (n = 35) for 12 weeks.

Focal central neurological disorder in patients with autoimmune thyroid disease without encephalopathy.

The report underscores the necessity for a comprehensive evaluation in patients with suggestive laboratory findings or AITD history. Prompt diagnosis and appropriate management are imperative in averting long-term complications.

Iranian specialists' approach to surgery in patients with multiple sclerosis.

Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists' approach to surgical counseling for patients with MS (PwMS). 21 MS specialists were asked about 11 case scenarios with different MS disease statuses, disease-modifying therapies (DMTs), and urgency of the operation.

Iranian specialists' approach to treatment escalation in multiple sclerosis patients with cognitive impairment.

People with multiple sclerosis ‎(MS) and their physicians recognize cognitive retention as an important desired outcome of disease-modifying therapies (DMTs). In this study, we attempted to gather the opinions of Iranian MS experts regarding the treatment approach toward clinical cases with different physical and cognitive conditions. Opinions of 20 MS specialists regarding the best approach to 6 case scenarios (with different clinical, cognitive, and imaging characteristics) were gathered via a form.

Investigation of the safety of live attenuated varicella-zoster virus vaccination in patients with relapse-remitting multiple sclerosis treated with natalizumab: A case series and review of the literature.

Introduction: It is generally recommended to avoid live attenuated vaccines in patients treated with high efficacy disease-modifying treatment (DMT). However, a delay in starting DMT in highly active or aggressive multiple sclerosis (MS) might lead to a significant disability.

Objective: We aimed to report a case series of 16 highly active RRMS patients who received the live-attenuated varicella-zoster virus (VZV) vaccine during treatment with natalizumab.

Soft Palate Malignant Melanoma as an Adverse Effect of Fingolimod in Multiple Sclerosis: A Case Report and Literature Review.

Fingolimod has been approved as a disease-modifying drug in multiple sclerosis since 2010. There are a few reports of melanoma as a side effect of Fingolimod in the literature. Herein we aim to report a known case of multiple sclerosis under Fingolimod presenting with persistent nasal congestion who was eventually diagnosed with soft palate malignant melanoma.

Effectiveness and safety of switching from fingolimod and natalizumab to rituximab in patients with relapsing remitting multiple sclerosis.

Introduction: Natalizumab and fingolimod are well-established, sequestrating disease-modifying treatments (DMTs), widely used as a second-line treatment in patients with relapse remitting multiple sclerosis (RRMS). However, there is no standard strategy for managing treatment failure on these agents. The present study aimed to evaluate the effectiveness of rituximab after natalizumab and fingolimod withdrawal.

Safety and efficacy of endovascular thrombolysis in patients with acute cerebral venous sinus thrombosis: A systematic review.

Introduction: Cerebral venous sinus thrombosis (CVST) is an uncommon but fatal cause of stroke worldwide. Endovascular treatments could be life-saving in patients who don't treat with anticoagulants as a mainstay of treatment. Currently, there is no consensus considering the safety, efficacy, and also selected approaches of endovascular intervention for these patients.

Characteristics and management of multiple sclerosis patients during the Omicron era: is there a concern about the MS course in the face of the new variant of COVID-19?

Introduction: The Omicron variant of COVID-19 is highly transmissible, triggering unprecedented infection rates. The present study aimed to investigate the course of multiple sclerosis (MS) in the Omicron era among Iranian patients with MS.

Methods: This observational study was designed on MS patients of the national MS registry of Iran through a self-designed online questionnaire.

Watch out for neuromyelitis optica spectrum disorder onset or clinical relapse after COVID-19 vaccination: What neurologists need to know?

Introduction: The ongoing global COVID-19 pandemic has dramatically impacted our lives. We conducted this systematic review to investigate the safety of the COVID-19 vaccines in NMOSD patients.

Methods: We systematically searched PubMed, Scopus, Web of Science, and Embase from the beginning of the COVID-19 vaccination to March 1, 2022.

Evaluation of domperidone efficacy to prevent aspiration pneumonia in patients with acute ischemic stroke: a randomized clinical trial.

Background And Aim: Aspiration pneumonia is an essential complication of acute ischemic stroke (AIS), which is responsible for increased three-fold mortality within a month. There is an interest towards the effect of prokinetics on prevention of stroke-associated pneumonia. The present study aimed to investigate the effect of domperidone to prevent pneumonia in patients with AIS.

Therapeutic Plasma Exchange (TPE) Complications in Patients With Multiple Sclerosis (MS) and Clinically Isolated Syndrome (CIS): A Report From a Tertiary Center.

Background: Therapeutic plasma exchange (TPE) is a conventional second-line treatment for patients with multiple sclerosis (MS) or clinically isolated syndrome with steroid-refractory relapses.

Methods: MS and clinically isolated syndrome patients with a steroid-refractory relapse, who fulfilled the indications for TPE were enrolled in this study. An expert nurse recorded the data comprising age, sex, type of MS, disease modifying therapy, disease duration, relapse rate, vital signs at the beginning, during and at the end of each plasma exchange session, plasma exchange volume, normal saline volume, and TPE complications.

A one year follow of patients with multiple sclerosis during COVID-19 pandemic: A cross-sectional study in Qom province, Iran.

Background: In the current COVID-19 pandemic, Multiple Sclerosis (MS) patients represent a population of particular interest as they might be at higher risk of COVID-19 infection and it's complications. The present study aimed to investigate a one year follow up of patients with MS during the COVID-19 pandemic, in Qom province, Iran.

Methods: This study was performed at the MS Clinic of Beheshti Hospital from June 1, 2020 to November 1, 2021.

Recurrence of COVID-19 in a Patient With NMO Spectrum Disorder While Treating With Rituximab: A Case Report and Review of the Literature.

Introduction: In the context of coronavirus disease 2019 (COVID-19) pandemic, patients with neuromyelitis optica spectrum disorder (NMOSD) are vulnerable to develop COVID-19 due to the immunosuppressive therapy. The objective of this study is to describe a known case of NMOSD on rituximab who experienced 2 episodes of COVID-19.

Case Report: A 25-year-old woman, a known case of NMOSD on rituximab was diagnosed with asymptomatic COVID-19.