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The new insights presented at European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held in the city of Gothenburg, Sweden, in October 2010, have been summarized at the third edition of Post-ECTRIMS meeting held in Madrid in November 2010. Encouraging findings from the 5-years follow up extension from PreCISe study confirm the benefit of early treatment with glatiramer acetate in patients with clinically isolated syndromes (CIS) against the conversion to clinically definitive multiple sclerosis and cerebral atrophy with an adequate safety and tolerability. Regarding treatment decision with escalation or induction therapy, different strategies have been proposed depending on to the characteristics of the individual patient with CIS. Findings from several of the reported studies have revealed the favorable role of combined therapy on relapse rate but not on magnetic resonance parameters in patients with recurrent-remittent multiple sclerosis. Novel therapies such as alemtuzumab, daclizumab ofatutumab or ocrelizumab have shown promising findings regarding efficacy. Nevertheless, safety findings for these emerging therapies have detected some severe adverse events, the main ones being potentially fatal opportunistic infections such as progressive multifocal leukoencephalopathy (PML) caused by JC virus, mainly linked to natalizumab treatment. In this regard, clinicians will face the assessment of he benefit-risk ratio when deciding on the adequate treatment for each patient in the clinical setting. In this regard, determination of antibodies to JC virus by a novel two-step enzyme-linked immunosorbent assay (ELISA) could provide clinicians with a useful tool to stratify PML risk in patients. Regarding non pharmacologic therapies, behavioral intervention has emerged as an effective therapy in the treatment of depression in multiple sclerosis, showing additional benefits on fatigue, disability and adherence to treatment.

Previous papers have mainly demonstrated the presence of cognitive impairment in patients with multiple sclerosis (MS), these changes have been traditionally associated with the later stages of the disease. In the current study, a comprehensive neuropsychological battery was administered to 216 relapsing-remitting MS patients with mild clinical disability (EDSS

Introduction and Method: In recent years the need to create scales for measuring the dysfunction or impairment suffered by patients with multiple sclerosis has increased. The aim of the scales that measure neurological impairment is two fold: to homogenise the data from different series so that studies into the prognosis and natural history of the disease can be compared, and to measure the changes in the progress of the disease when a therapy has been established. Over the past few years a large number of scales have appeared that attempt to redress the shortcomings of the EDSS (Expanded Disability Status Scale). The latest of these, the MSF Composite, manages to overcome the statistical problems of the EDSS and enables significant differences between two groups to be detected when studying the effect of a treatment., Conclusions: In the coming years we will possibly witness a joint use of several of the scales described, and both the EDSS and the Composite will be employed together in the evaluation of patients in therapeutic protocols, perhaps together with a quality of life scale.

The presence of axonal lesions in plaques of demyelination in patients with multiple sclerosis (MS) has been known for many years. Traditionally it was believed that axonal loss occurred in chronic lesions. However, demonstration of pathological degeneration in active plaques, use of new resonance techniques such as spectroscopy or the transfer of magnetization, showing axonal damage in white matter of apparently normal aspect, and the presence of axonal neurofilaments in the cerebrospinal fluid during the episode has made it necessary to reconsider the contribution made by axonal damage to the pathogenesis of MS. Besides, recent studies have shown that a factor present in the cerebrospinal fluid of patients with MS may contribute to the induction of neuronal apoptosis. These facts, apart from their pathogenic implications and consequent clinical repercussions, will affect investigation of alternative treatments for this disorder, and by means of clinico-immunoradiological correlation will help to define the prognosis of the course of the disorder in these patients.

Spatial and temporal dissemination of demyelinating lesions continue to provide the basis for diagnosing multiple sclerosis (MS). We describe 20 patients (from a series of 234 with MS) who experienced flare-ups consistent with sensory suspension syndrome (SSS). The presence of syringomyelic cavities (non communicating syringomyelia) was ruled out by nuclear magnetic resonance imaging (NMR). We discuss the possible locations of lesions responsible for this syndrome: the trigeminus, dorsal root entry zones, anterior medullary white matter, and the mid-lateral portion of the spinothalamic tract. MS should be included as a differential diagnosis in young patients presenting with SSS.