Multiple Sclerosis and Related Disorders

August 2022, Volume 28, Issue 4
BROWSE ISSUES

Multiple Sclerosis and Related Disorders

August 2022, Vol.28, No.4

Guest Editor:

Myla D. Goldman, MD, MSc, FAAN

Editor-in-Chief:

STEVEN L. LEWIS, MD, FAAN

ISSN: 1080-2371

Online ISSN: 1538-6899

REVIEW ARTICLES
Epidemiology and Pathophysiology of Multiple Sclerosis
Ward, Melanie; Goldman, Myla D.
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 988-1005
doi: 10.1212/CON.0000000000001136
Diagnosis of Multiple Sclerosis
Oh, Jiwon
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1006-1024
doi: 10.1212/CON.0000000000001156
Treatment of Multiple Sclerosis
Cross, Anne; Riley, Claire
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1025-1051
doi: 10.1212/CON.0000000000001170
Approach to Symptom Management in Multiple Sclerosis With a Focus on Wellness
Spain, Rebecca
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1052-1082
doi: 10.1212/CON.0000000000001140
Progressive Multiple Sclerosis
Amezcua, Lilyana
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1083-1103
doi: 10.1212/CON.0000000000001157
Pediatric Acquired Demyelinating Disorders
Brenton, J. Nicholas
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1104-1130
doi: 10.1212/CON.0000000000001128
Neuromyelitis Optica Spectrum Disorders
Costello, Fiona
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1131-1170
doi: 10.1212/CON.0000000000001168
Myelin Oligodendrocyte Glycoprotein–Associated Disorders
Longbrake, Erin
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1171-1193
doi: 10.1212/CON.0000000000001127
Leukodystrophies
Adang, Laura
CONTINUUM: Lifelong Learning in Neurology
August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders - p 1194-1216
doi: 10.1212/CON.0000000000001130
Editor's Preface
Articles
Key Points
Abbreviations
Appendix
Issue Overview
STEVEN L. LEWIS, MD, FAAN

Editor-in-Chief:

STEVEN L. LEWIS, MD, FAAN

True, True, and Unrelated

CONTINUUM: Lifelong Learning in Neurology August 2022 - Volume 28 - Issue 4, Multiple Sclerosis and Related Disorders -p 986-987 doi: 10.1212/CON.0000000000001215

This issue of Continuum is devoted to the diagnosis and management of our patients with multiple sclerosis (MS) and other, predominantly inflammatory, disorders that can affect the white matter of the central nervous system. Although it is true that the disorders discussed in this issue may resemble each other clinically and on imaging, they represent distinct etiopathologic entities (despite the term related disorders in the title) that need to be carefully teased out to provide the most appropriate diagnosis, counseling, and management for our patients. To accomplish this objective, I am thankful to Dr Myla D. Goldman for accepting my invitation to serve as the guest editor of the issue and for enlisting such outstanding subject matter experts and educators to provide us with the most up-to-date information and recommendations on these disorders whose clinical spectrum and management options continue to rapidly unfold.

The issue begins with the article by Dr Melanie Ward and Dr Goldman, who provide an introduction to many of the subsequent articles in this issue as they summarize what is currently known about the epidemiology and pathophysiology of MS as well as its risk factors. In the next article, Dr Jiwon Oh provides a review of the diagnosis of MS and the most current diagnostic criteria for its various clinical forms while also pointing out important red flags that suggest an alternative diagnosis.

Drs Anne Cross and Claire Riley then discuss the many options now available for the treatment of MS, describing overall management strategies as well as the risks and benefits of each medication that the clinician needs to have at hand to provide the best patient-centered joint decision making. Next, Dr Rebecca Spain describes an approach to symptom management in MS, focusing on healthy lifestyle practices and nonpharmacologic symptom management as well as discussing the risks and potential benefits of pharmacologic and procedural symptom management strategies and their various levels of evidence. Dr Lilyana Amezcua then reviews the progressive forms of MS (primary progressive MS and secondary progressive MS), including their definitions, diagnosis, and management options and the importance of early identification of these forms of the disease.

Dr J. Nicholas Brenton next reviews the various forms of pediatric acquired demyelinating disorders (including initial presentations such as optic neuritis, acute “transverse” myelitis, or acute disseminated encephalomyelitis) and relapsing forms of the disease (eg, pediatric MS, neuromyelitis optica spectrum disorders [NMOSD], and myelin oligodendrocyte glycoprotein [MOG]–associated disorders) and their diagnosis and management options in this age group.

Dr Fiona Costello next extensively reviews NMOSD, including its categorization as an autoimmune astrocytopathy, clinical features, diagnostic criteria, prognosis, and evolving management options, as well as a discussion of evolving biomarkers of this potentially disabling condition. Next, Dr Erin Longbrake similarly extensively reviews MOG–associated disorders, relatively recently recognized central nervous system autoimmune syndromes whose myriad clinical and diagnostic features and management options are rapidly being elucidated.

In the final review article of the issue, Dr Laura Adang reviews the clinical features, diagnosis, and emerging therapeutic options of the leukodystrophies, conditions (whether demyelinating or hypomyelinating) that can clinically resemble, and may be a differential diagnostic consideration for, the acquired inflammatory and demyelinating conditions described in this issue.

After reading the issue and taking the Postreading Self-Assessment and CME Test written by Drs Adam G. Kelly and Allison L. Weathers and edited by Dr Joseph E. Safdieh, associate editor of Continuum and associate editor of self-assessment and CME, readers may earn up to 20 AMA PRA Category 1 CreditsTM toward self-assessment CME or, for Canadian participants, a maximum of 20 hours toward the Self-Assessment Program (Section 3) of the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. Additional credit can be obtained by listening to Continuum Audio interviews associated with this and other Continuum issues, available to all subscribers, and completing tests on the Continuum Audio web platform or mobile app. Continuum Audio is also accredited by the Royal College of Physicians and Surgeons of Canada.

This issue also features Continuum articles read aloud. Different from Continuum Audio, these are recordings read verbatim from the print articles. The audio files are available to all Continuum subscribers in the AAN’s Online Learning Center at continpub.com/CME. I encourage you to listen and submit the survey with your feedback.

I would like to offer my sincere thank you to Dr Goldman for her outstanding work creating, organizing, and honing this issue and to the wonderful group of experts she brought on board, each of whom wrote state-of-the-art reviews of the increasingly complex individual topics to complete the overall issue theme. The result is an issue of Continuum that prepares us well to diagnose, counsel, and manage patients with any of the many disorders that may present to us that predominantly, but not exclusively, involve the white matter of the brain, optic nerves, and spinal cord.

…I am thankful to Dr Myla D. Goldman for accepting my invitation to serve as the guest editor of the issue and for enlisting such outstanding subject matter experts and educators to provide us with the most up-to-date information and recommendations on these disorders…

—STEVEN L. LEWIS, MD, FAAN
EDITOR-IN-CHIEF

© 2022 American Academy of Neurology.