Fernandez O, Oterino A, Oreja-Guevara C, Prieto J M, Mendibe-Bilbao M M, Garcia-Merino J A, Ramio-Torrenta Ll, Ginestal R, Meca-Lallana J E, Romero-Pinel L, Munoz D, Oliva-Nacarino P, Calles-Hernandez M C, Izquierdo G, Martinez-Gines M L, Saiz A, Comabella M, Casanova-Estruch B, Brieva Ll, Arroyo R, Rodriguez-Antiguedad A
Hospital Regional Universitario de Malaga, Malaga, Espana.
Hospital Universitario Marques de Valdecilla, Santander, Espana.
Rev Neurol. 2017 Jul 1;65(1):31-40.
For the ninth year in a row the Post-ECTRIMS Meeting has been held in Madrid (Spain) with the aim of presenting and discussing the hottest issues debated at the ECTRIMS Congress by renowned specialists in multiple sclerosis in our country. One outcome of this scientific activity, endorsed by the Spanish Neurology Society, is this review article, which is published in two parts. This first part addresses family planning, pregnancy management and the role of breastfeeding in women with multiple sclerosis. Attention is drawn to the paediatric population, to magnetic resonance imaging features and to the genetic-environmental risk factors for developing the disease in children, without neglecting the risk factors for development in adults. The review updates the epidemiology of cognitive deterioration in patients with multiple sclerosis, the advantages and disadvantages of available assessment tools, and current management approaches, while also insisting on the importance of cognitive involvement during the course of the disease. Furthermore, the concept of individualised, precision medicine is introduced, from the diagnosis of the disease until its treatment, with the controversies that inevitably arise in patient management, above all with regard to the change of treatment and the handling of associated risks.
ECTRIMS会后会议已连续九年在西班牙马德里举行，目的是由我国多发性硬化症领域的知名专家介绍和讨论ECTRIMS大会上热议的最热门问题。这项得到西班牙神经病学学会认可的科学活动的一个成果就是这篇综述文章，它分两部分发表。第一部分探讨了多发性硬化症女性的计划生育、妊娠管理以及母乳喂养的作用。文章还关注了儿科人群、磁共振成像特征以及儿童患该病的遗传环境风险因素，同时也没有忽视成人发病的风险因素。该综述更新了多发性硬化症患者认知功能衰退的流行病学、现有评估工具的优缺点以及当前的管理方法，同时强调了疾病过程中认知功能受累的重要性。此外，还介绍了从疾病诊断到治疗的个体化精准医学概念，以及患者管理中不可避免出现的争议，尤其是在治疗变更和相关风险处理方面。
