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Clin. Transl. Neurosci., Volume 8, Issue 3 (September 2024) – 2 articles

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30 pages, 448 KiB  
Review
Recommendations for the Treatment of Multiple Sclerosis in Family Planning, Pregnancy and Lactation in Switzerland: Immunotherapy
by Michael Graber, Alice Panchaud, Helene Legardeur, Tobias Derfuss, Christoph Friedli, Claudio Gobbi, Chiara Zecca, Cristina Granziera, Ilijas Jelcic, Helly Noemi Hammer, Sandra Bigi, Lara Diem, Nicole Kamber, Veronika Kana, Jens Kuhle, Stefanie Müller, Anke Salmen, Robert Hoepner, Philipp Do Canto, Marie Théaudin, Daniel Surbek, Caroline Pot and Andrew Chanadd Show full author list remove Hide full author list
Clin. Transl. Neurosci. 2024, 8(3), 26; https://doi.org/10.3390/ctn8030026 - 1 Aug 2024
Viewed by 537
Abstract
A large number of disease-modifying immunotherapies are available for the treatment of people with multiple sclerosis. Many disease-modifying immunotherapies show scarce or no safety data in pregnancy and breastfeeding and are labeled as being contraindicated during these periods in the Swiss summary of [...] Read more.
A large number of disease-modifying immunotherapies are available for the treatment of people with multiple sclerosis. Many disease-modifying immunotherapies show scarce or no safety data in pregnancy and breastfeeding and are labeled as being contraindicated during these periods in the Swiss summary of product characteristics. Some disease-modifying immunotherapies also have restrictions for male patients. Hence, family planning should always be considered in treatment decisions. If clinically necessary, the continuation of immunotherapy during pregnancy can be considered for some substances. In these situations, the “Good Off-Label Use Practice”, careful consideration of the benefit–risk profile, and interprofessional cooperation between the treating neurologist, obstetrician–gynecologist, and pharmacist/pharmacologist, ideally with the involvement of experienced centers, is necessary. Here, we present an update on disease-modifying immunotherapies in multiple sclerosis with a focus on family planning, pregnancy, and breastfeeding and provide consensus recommendations of the Medico-Scientific Advisory Board of the Swiss Multiple Sclerosis Society, the Swiss Neurological Society, and the Swiss Society for Gynecology and Obstetrics (represented by the Academy of Fetomaternal Medicine). These unified national recommendations are necessary, as guidelines from other countries differ and because of separate approval/reimbursement situations in Switzerland. Full article
23 pages, 741 KiB  
Review
Pediatric Narcolepsy Type 1: A State-of-the-Art Review
by Valentina Baldini, Francesco Biscarini, Giorgia Varallo, Fabio Pizza and Giuseppe Plazzi
Clin. Transl. Neurosci. 2024, 8(3), 25; https://doi.org/10.3390/ctn8030025 - 30 Jun 2024
Viewed by 507
Abstract
Narcolepsy is a chronic central disorder of hypersomnolence most frequently arising during childhood/adolescence. This review article examined the literature concerning the etiology, prevalence, clinical course, and treatment of children with type 1 narcolepsy (NT1). Core symptoms of pediatric NT1 include excessive daytime sleepiness [...] Read more.
Narcolepsy is a chronic central disorder of hypersomnolence most frequently arising during childhood/adolescence. This review article examined the literature concerning the etiology, prevalence, clinical course, and treatment of children with type 1 narcolepsy (NT1). Core symptoms of pediatric NT1 include excessive daytime sleepiness (EDS) and cataplexy, together with disrupted night sleep, sleep paralysis, and hypnagogic and hypnopompic hallucinations that can also occur. This disease frequently presents several comorbidities, such as obesity and precocious puberty, conditions ranging from psychological distress to psychiatric disorders, and cognitive aspects that further worsen the clinical picture. NT1 impairs the quality of life of children, thus calling for an early diagnosis and adequate treatment. To date, pharmacological treatments have been registered for childhood NT1 and can improve symptoms. Non-pharmacological approaches are also essential to improve patients’ well-being, ranging from behavioral treatments (e.g., planned napping) to psychosocial interventions (e.g., school programs). Multidisciplinary treatment management and early diagnosis are key factors in order to allow for adequate quality of life and development in children with NT1. Full article
(This article belongs to the Section Neuroscience/translational neurology)
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