Tables for:
Demyelinating Diseases
 


Table 1. Demyelinating Diseases of the Central Nervous System


Type Disease
Immune-mediated Recurrent
  Multiple sclerosis
Monophasic
  Optic neuritis
  Transverse myelitis
  Acute disseminated encephalomyelitis
Inherited Adrenoleukodystrophy
Metachromatic leukodystrophy
Metabolic Vitamin B12 deficiency
Central pontine myelinolysis
Infectious Progressive multifocal leukoencephalopathy
Subacute sclerosing panencephalitis

Table 2. Appropriate Distribution of Neurologic Deficits at Onset of MS and after 5 to 10 Years of Disease[82,83]


Deficits At Onset (%) 5 to 10 Years after Onset (%)
Cognitive deficits
Visual deficits
Diplopia
Weakness
Ataxia
Sensory deficits
Bowel or bladder
  symptoms
< 5
20-30
10-20
40
5-20
40
5-10
30
50
35
80
65
80
55

Table 3. Diagnostic Criteria for Multiple Sclerosis*[19]


Type Criteria
Clinically definite MS Two attacks and clinical evidence of two
  separate lesions
                                    or
Two attacks, clinical evidence of one lesion,
  paraclinical evidence of a second lesion
Laboratory-supported
  definite MS
Oligoclonal bands or increased IgG synthesis
  in the CSF
                                    and
Two attacks and clinical or paraclinical
  evidence of one lesion
                                    or
One attack and clinical evidence of two lesions
                                    or
One attack, clinical evidence of one lesion,
  paraclinical evidence of a second lesion
Clinically probable MS Two attacks and clinical evidence of one lesion
                                    or
One attack and clinical evidence of two lesions
                                    or
One attack, clinical evidence of one lesion,
  paraclinical evidence of a second lesion

*In this table, the term clinical evidence denotes the presence of signs on neurologic examination. Signs documented in the past by a competent examiner fulfill the criteria, even if they have resolved. Paraclinical evidence is the demonstration of lesions that do not cause clinical signs by laboratory testing (e.g., neuroimaging or evoked responses).


Table 4. Symptomatic Therapy for MS*


Indication Drug Dosage
Fatigue Amantadine hydrocloride
Pemoline
Methylphenidate hydrochloride
Modafinil
100 mg b.i.d. or t.i.d.
37.5 to 112.5 mg q.d.
10 mg b.i.d. to 20 mg t.i.d.
100 mg b.i.d.
Bladder
  Urgency




  Dyssynergia


  Retention

Oxybutynin chloride
Tolterodine tartrate
Imipramine hydrochloride
Hyoscyamine sulfate
Propantheline bromide
Phenoxybenzamine hydrochloride
Clonidine
Terazosin hydrochloride
Intermittent catheterization
Bethanechol chloride

5 mg b.i.d. to q.i.d.
2 mg b.i.d.
25 to 75 mg q.h.s.
0.125 mg b.i.d. to 0.25 mg q.i.d.
7.5 mg t.i.d. to 15 mg q.i.d.
10mg b.i.d. to 20 mg t.i.d.
0.1 mg b.i.d. to 0.2 mg t.i.d.
1 to 5 mg q.d.
Four or more times daily
10 mg t.i.d. to 50 mg q.i.d.
Spasticity





Ataxia
Baclofen
Diazepam
Tizanidine hydrochloride
Clonazepam
Clonidine (adjunctive to baclofen)
Dantrolene sodium
Clonazepam
Gabapentin
5 mg t.i.d. to 20 mg q.i.d.
2 mg t.i.d. to 10 mg q.i.d.
4 mg q.d. to 12 mg q.i.d.
0.5 mg t.i.d. to 5 mg q.i.d.
0.1. mg b.i.d. to 0.2 mg t.i.d.
25 mg q.d. to 100 mg q.i.d.
0.5 mg t.i.d. to 5 mg q.i.d.
100 to 600 mg t.i.d.
Pain
  Paroxysmal


  Dysesthetic



Carbamazepine
Phenytoin
Misoprostol (trigeminal neuralgia)
Amitriptyline hydrochloride
Phenytoin
Gabapentin
Valproic acid

100 to 300 mg t.i.d.
300 to 400 mg q.d.
100 to 200 g q.i.d.
50 to 150 mg q.h.s.
300 to 400 mg q.d.
100 to 600 mg t.i.d.
250 to 1,000 mg t.i.d.

*Usual adult dose for medications commonly used to treat MS syndromes. See appropriate reference for complete prescribing information, including contraindications, warnings, side effects, and initiation and termination of treatment.