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Patterns of blood-brain barrier impairment and clinical features in multiple sclerosis.
  1. B N McLean,
  2. A Z Zeman,
  3. D Barnes,
  4. E J Thompson
  1. Department of Neurology, National Hospitals for Neurology and Neurosurgery, London.


    Seventy four patients with clinically definite multiple sclerosis were studied by using polyacrylamide gel electrophoresis of cerebrospinal fluid to assess blood-brain barrier function. Blood-brain barrier impairment was associated with recent clinical relapses of multiple sclerosis and worsened across a spectrum from the relapsing-remitting type of multiple sclerosis to secondary and primary progressive disease. The association between blood-brain barrier impairment and primary progressive disease is particularly interesting in the light of recent evidence that focal gadolinium enhancement on MRI is relatively unusual in patients with this disease.

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