Exacerbations of multiple sclerosis before and after surgery
| Study [ref] | n | Exacerbation-free baseline (months) | Follow up period for exacerbation data (months) | Postoperative exacerbations | Comments |
|---|---|---|---|---|---|
| In general, the papers did not give specific criteria for exacerbation, but did provide clinical descriptions (summarised here). | |||||
| EDSS, expanded disability status scale; MS, multiple sclerosis; MRI, magnetic resonance imaging; UTI, urinary tract infection. | |||||
| Brice and McLellan, 1980 7 | 2 | 6 months | 5–6 months | 0 | No changes in clinical status consistent with relapse occurred |
| Geny et al, 1996 11 | 13 | 6 months | 12 months | 3 | Three patients had a relapse of their MS at 4, 6, and 12 months postsurgery, respectively; no change in average EDSS for the group |
| Montgomery et al, 1999 3 | 14 | 6 months | <3–12+ months | 1 | One patient had an exacerbation 3 days postsurgery, at the time of a UTI. This decreased the patient’s lower extremity power and necessitated increased use of a wheelchair |
| Schulder et al, 1999 2 | 5 | Not specified | ⩾6 months | 2 | Two patients had an exacerbation within one month of surgery; both responded to high dose intravenous steroids. In one, new brain stem lesions were evident on MRI but not near the site of the electrode. No change in individuals’ EDSS scores |
| Matsumoto et al, 2001 16 | 3 | 3 months | 12 months | 0 | No exacerbations |
| Nandi et al, 2002 18 | 1 | Not specified; had progressive worsening of tremor in the 6 months before surgery | 12 months | ? | The patient experienced progressive worsening of walking, and left foot dystonia developed between approximately 9 and 12 months post-surgery. It is unclear whether this represented a discrete relapse or continuation of the progression that was evident before surgery |