2018 年 34 巻 5 号 p. 500-505
We reviewed recent advances and new evidence related to treatment for immune–mediated central nervous system disorders particularly multiple sclerosis (MS) and neuromyelitis optica (NMO).
In Japan, new disease modifying drugs (DMDs) for MS were approved every year for the last three years, therefor we should know the efficacy and safety about each DMD and how to use it for MS patients. DMDs reduce the relapse rate in MS patients but some DMDs are associated with a risk of progressive multifocal leukoencephalopathy (PML). Because of the frequently poor prognosis of PML, it is importance to establish this diagnosis at an early asymptomatic stageusing the basis of magnetic resonance imaging (MRI) and JCV DNA. Additionally pregnancy and the use of DMDs, rebound syndrome, lateral and escalation therapy in relapsing remitting MS were reviewed.
We also reviewed neuromyeltisoptica (NMO). It is difficult to diagnose a patient with aquaporin 4 (AQP4) IgGseronegative NMO. MOG–Ig G seropositive NMO is one of the AQP4 IgGseronegative NMO, It's clinical presentation, radiological and laboratory features, treatment response and so on were reported in details in 2016.
