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Journal of Neurosurgical Sciences 2004 September;48(3):135-7

Copyright © 2005 EDIZIONI MINERVA MEDICA

lingua: Inglese

Prophylaxis to avert exacerbation/relapse of multiple sclerosis in affected patients undergoing surgery. Surgical observations and recommendations

Dickerman R. D. 1, Schneider S. J. 2, Stevens Q. E. 2, Matarese N. M. 2, Decker R. E. 2

1 Department of Neurosurgery Plano Presbyterian Hospital and Texas Back Institute Plano, TX, USA
2 Departtment of Neurosurgery North Shore University Hospital Long-Island Jewish Health System New Hyde Park, NY, USA


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To pro­vide the neu­ro­log­i­cal and neu­ro­sur­gi­cal com­mu­nities ­with ­case evi­dence of post­op­er­a­tive mul­ti­ple scler­o­sis (MS) ­relapse, lit­er­a­ture ­review to sup­port oper­a­tive ­stress-­induced ­relapse and rec­om­men­da­tions for per­i­op­er­a­tive pro­phy­lax­is to pre­vent ­relapse in ­patients under­go­ing sur­gery. Two ­case stud­ies are pre­sent­ed ­with rec­om­men­da­tions ­based on an exten­sive ­review of the med­i­cal lit­er­a­ture and per­son­al expe­ri­ence to sup­port per­i­op­er­a­tive pro­phy­lac­tic sug­ges­tions. Both ­patients ful­ly recov­ered to pre­op­er­a­tive func­tion­al stat­us ­after treat­ment. We now rou­tine­ly imple­ment per­i­op­er­a­tive pro­phy­lax­is to MS ­patients under­go­ing sur­gery at our insti­tu­tion ­with no com­pli­ca­tions to ­date. Perioperative pro­phy­lax­is in ­patients ­with MS under­go­ing sur­gery can pre­vent ­relapse. It is of ­utmost impor­tance ­that the sur­gi­cal com­mu­nity realiz­es ­that pro­phy­lac­tic treat­ment is avail­able and ­should be uti­lized dur­ing elec­tive and emer­gent sur­gi­cal sit­u­a­tions.

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