2022
Challenges in the Clinical Recognition of Acute Flaccid Myelitis and its Implications
Hayes LH, Hopkins SE, Liu S, Pardo CA, Garcia-Dominguez MA, Oleszek J, Yea C, Ciftci-Kavaklioglu B, Yeh EA, Dean J, Sadowsky CL, Desai J, Wiegand S, Farias-Moeller R, Nash K, Thakur KT, Vargas WS, Hong-Routson SJ, Yeshokumar A, Zhou MS, Makhani N, Wilson-Murphy M, Bove R, Zhang B, Benson LA. Challenges in the Clinical Recognition of Acute Flaccid Myelitis and its Implications. The Journal Of Pediatrics 2022, 253: 55-62.e4. PMID: 36115622, DOI: 10.1016/j.jpeds.2022.09.012.Peer-Reviewed Original ResearchConceptsAcute flaccid myelitisInitial diagnosisCase definitionRetrospective multicenter studyPrevention case definitionInitial differential diagnosisNew treatment optionsInitial clinical encounterIntensive care monitoringRespiratory decompensationImmunomodulatory treatmentIntravenous immunoglobulinVentilatory supportPediatric patientsClinical featuresAcute careMulticenter studyTreatment optionsClinical recognitionTreatment paradigmClinical impactDifferential diagnosisPatientsDisease controlClinical encounters
2020
Acute flaccid myelitis: cause, diagnosis, and management
Murphy O, Messacar K, Benson L, Bove R, Carpenter J, Crawford T, Dean J, DeBiasi R, Desai J, Elrick M, Farias-Moeller R, Gombolay G, Greenberg B, Harmelink M, Hong S, Hopkins S, Oleszek J, Otten C, Sadowsky C, Schreiner T, Thakur K, Van Haren K, Carballo C, Chong P, Fall A, Gowda V, Helfferich J, Kira R, Lim M, Lopez E, Wells E, Yeh E, Pardo C, group A, Salazar-Camelo A, Mithal D, Wilson-Murphy M, Bauer A, Watkins C, Abzug M, Dominguez S, Press C, Yang M, Ahsan N, Ramos-Platt L, Tiongson E, Seruya M, Tilton A, Katz E, Kirschen M, Shah A, Ulloa E, Yum S, Mondok L, Blaufuss M, Rosenfeld A, Vargas W, Zucker J, Yeshokumar A, Navis A, Chao K, Hagen K, Melicosta M, Porter C, Tunney M, Scheuermann R, Duggal P, Pekosz A, Bayliss A, Moore M, Belzberg A, Bembea M, O'Brien C, Riggs R, Nance J, Milstone A, Rice J, Garcia-Dominguez M, Flanagan E, Tillema J, Bosques G, Bhatia S, Gordon-Lipkin E, Deike D, Revivo G, Zlotolow D, deFiebre G, Lazerow P, Lotze T, Bitnun A, Davidge K, Vajsar J, Moore A, Konersman C, Nash K, Strober J, Gupta N, Chiu C, Sweeney M, Jackson W, Simon D, Thakkar K, Cheng J, Luce J, Das S, Vogt M, Vu N, Gofshteyn J, Makhani N, Patel P. Acute flaccid myelitis: cause, diagnosis, and management. The Lancet 2020, 397: 334-346. PMID: 33357469, PMCID: PMC7909727, DOI: 10.1016/s0140-6736(20)32723-9.Peer-Reviewed Original ResearchConceptsAcute flaccid myelitisNon-polio enterovirus infectionMajor public health challengeAcute neurological illnessCerebrospinal fluid characteristicsPolio-like illnessSubstantial residual disabilityProfound muscle weaknessLong-term outcomesTargeted therapeutic approachesPublic health challengeLong-term rehabilitationResidual disabilityAcute phaseClinical featuresClinical presentationEnterovirus infectionImmunological featuresMuscle weaknessNeurological illnessTherapeutic approachesHost-virus interactionsPathogen factorsHealth challengesDiagnosisRadiologically Isolated Syndrome: 10‐Year Risk Estimate of a Clinical Event
Lebrun‐Frenay C, Kantarci O, Siva A, Sormani M, Pelletier D, Okuda D, Azevedo C, Amato M, Bensa C, Berger E, Brochet B, Ciron J, Cohen M, Inglese M, Keegan B, Labauge P, Laplaud D, Le Page E, Louapre C, Makhani N, Mathey G, Mondot L, Montalban X, Pelletier J, Seze J, deStefano N, Thouvenot E, Tintore M, Tutuncuoglu M, Uygunoglu U, Vermersch P, Weinshenker B, Zeydan B. Radiologically Isolated Syndrome: 10‐Year Risk Estimate of a Clinical Event. Annals Of Neurology 2020, 88: 407-417. PMID: 32500558, DOI: 10.1002/ana.25799.Peer-Reviewed Original ResearchConceptsFirst clinical eventSubsequent clinical eventsGadolinium-enhancing lesionsSpinal cord lesionsClinical eventsRIS subjectsCord lesionsIndependent predictorsMultivariate Cox regression modelMagnetic resonance imaging (MRI) characteristicsBaseline independent predictorsWorldwide cohort studiesPositive cerebrospinal fluidCox regression modelAnn NeurolIsolated SyndromeRIS diagnosisCohort studySymptom onsetMale sexMultiple sclerosisOligoclonal bandsInfratentorial lesionsMean ageClinical managementMultiple Sclerosis in Children: Current and Emerging Concepts
Brenton JN, Kammeyer R, Gluck L, Schreiner T, Makhani N. Multiple Sclerosis in Children: Current and Emerging Concepts. Seminars In Neurology 2020, 40: 192-200. PMID: 32294785, PMCID: PMC8514113, DOI: 10.1055/s-0040-1703000.Peer-Reviewed Original Research
2019
Clinical trials of disease-modifying agents in pediatric MS: Opportunities, challenges, and recommendations from the IPMSSG
Waubant E, Banwell B, Wassmer E, Sormani M, Amato M, Hintzen R, Krupp L, Rostásy K, Tenembaum S, Chitnis T, Aaen G, Ben Adou E, Al-Roughani R, Alvarez V, Anagnostouli M, Anlar B, Armangue T, Arrambide G, Baroncini D, Bembeeva R, Benson L, Bizjak N, Blaschek A, Boyko A, Brenton J, Brück W, Klein da Costa B, Dive D, Elpers C, Filippi M, de Oliveira Fragomeni M, Havrdova E, Hemingway C, Kornek B, Deiva K, Lacy A, Liba Z, Lim M, Lotze T, Mah J, Makhani N, Mar S, McKay K, Menascu S, Moiola L, Mulero P, Ndiaye M, Neuteboom R, Ness J, Lobato de Oliveira E, Otallah S, Patti F, Albino da Paz J, Perez C, Pohl D, Ponsonby A, Rensel M, Rocca M, Rijke N, Rodriguez M, Rossman I, Sakuma H, Schreiner T, Schteinschnaider A, Sikes E, Simone I, Sweeney M, Tillema J, Troxell R, Verhelst H, Vilchez L, De Waele L, Weinstock-Guttman B, Wilbur C, Yann M, Yeh E, Zafeiriou D. Clinical trials of disease-modifying agents in pediatric MS: Opportunities, challenges, and recommendations from the IPMSSG. Neurology 2019, 92: 10.1212/wnl.0000000000007572. PMID: 31043474, PMCID: PMC6556085, DOI: 10.1212/wnl.0000000000007572.Peer-Reviewed Original Research
2018
Acquisition of Early Developmental Milestones and Need for Special Education Services in Pediatric Multiple Sclerosis
Aaen G, Waltz M, Vargas W, Makhani N, Ness J, Harris Y, Casper TC, Benson L, Candee M, Chitnis T, Gorman M, Graves J, Greenberg B, Lotze T, Mar S, Tillema JM, Rensel M, Rodriguez M, Rose J, Rubin J, Schreiner T, Waldman A, Weinstock-Guttman B, Belman A, Waubant E, Krupp L. Acquisition of Early Developmental Milestones and Need for Special Education Services in Pediatric Multiple Sclerosis. Journal Of Child Neurology 2018, 34: 148-152. PMID: 30556452, PMCID: PMC6579723, DOI: 10.1177/0883073818815041.Peer-Reviewed Original ResearchConceptsPediatric multiple sclerosisMultiple sclerosisEarly developmental milestonesPediatric Multiple Sclerosis CentersPediatric-onset multiple sclerosisMultiple sclerosis onsetMultiple Sclerosis CenterDevelopmental milestonesPediatric controlsDisease onsetHealthy controlsSclerosisAge 18Age 11ChildrenOnsetIndividualized education planFurther researchControlSafety, tolerability, and efficacy of fluoxetine as an antiviral for acute flaccid myelitis
Messacar K, Sillau S, Hopkins SE, Otten C, Wilson-Murphy M, Wong B, Santoro JD, Treister A, Bains HK, Torres A, Zabrocki L, Glanternik JR, Hurst AL, Martin JA, Schreiner T, Makhani N, DeBiasi RL, Kruer MC, Tremoulet AH, Van Haren K, Desai J, Benson LA, Gorman MP, Abzug MJ, Tyler KL, Dominguez SR. Safety, tolerability, and efficacy of fluoxetine as an antiviral for acute flaccid myelitis. Neurology 2018, 92: e2118-e2126. PMID: 30413631, PMCID: PMC6512883, DOI: 10.1212/wnl.0000000000006670.Peer-Reviewed Original ResearchConceptsAcute flaccid myelitisSerious adverse eventsFluoxetine-treated patientsEfficacy of fluoxetineEV-D68Initial examinationPoor long-term outcomesImproved neurologic outcomeMulticenter cohort studyClass IV evidenceAdverse effect ratesDose of fluoxetinePropensity-adjusted analysisLong-term outcomesUnexposed patientsNeurologic outcomeUntreated patientsAdverse eventsCohort studyPrimary outcomeUS patientsStudy criteriaEnterovirus D68PatientsEffect rateThe Radiologically Isolated Syndrome: An Opportunity to Prevent Multiple Sclerosis in Children
Makhani N. The Radiologically Isolated Syndrome: An Opportunity to Prevent Multiple Sclerosis in Children. Pediatric Neurology 2018, 85: 13-15. PMID: 30104110, DOI: 10.1016/j.pediatrneurol.2018.05.009.Peer-Reviewed Original Research
2017
MRI findings of optic pathway involvement in Miller Fisher syndrome in 3 pediatric patients and a review of the literature
Malhotra A, Zhang M, Wu X, Jindal S, Durand D, Makhani N. MRI findings of optic pathway involvement in Miller Fisher syndrome in 3 pediatric patients and a review of the literature. Journal Of Clinical Neuroscience 2017, 39: 63-67. PMID: 28209311, DOI: 10.1016/j.jocn.2016.12.049.Peer-Reviewed Original ResearchConceptsMiller Fisher syndromeOptic pathway involvementGuillain-Barré syndromeCranial nerve enhancementPediatric patientsFisher syndromeNerve enhancementPathway involvementCranial nerve involvementNerve involvementAcute illnessDemyelinating conditionMRI findingsBrighton criteriaClinical manifestationsOptic pathwayCase reportCranial nervesBrain MRIPatientsSyndromeInvolvementFindingsNerveIllnessAbnormal Fluid-Attenuated Inversion Recovery Signal in the Internal Capsule: A Novel Brain Magnetic Resonance Imaging Finding in a Child With Acute Flaccid Myelitis
Makhani N, Mahajan A. Abnormal Fluid-Attenuated Inversion Recovery Signal in the Internal Capsule: A Novel Brain Magnetic Resonance Imaging Finding in a Child With Acute Flaccid Myelitis. Pediatric Neurology 2017, 73: 108-109. PMID: 28262551, DOI: 10.1016/j.pediatrneurol.2017.01.031.Peer-Reviewed Original Research
2016
Pediatric multiple sclerosis
Ghezzi A, Amato MP, Makhani N, Shreiner T, Gärtner J, Tenembaum S. Pediatric multiple sclerosis. Neurology 2016, 87: s97-s102. PMID: 27572869, DOI: 10.1212/wnl.0000000000002823.Peer-Reviewed Original ResearchConceptsFirst-line treatmentPediatric multiple sclerosisMultiple sclerosisObservational studyRandomized placebo-controlled trialStandard first-line treatmentFirst-line treatment optionRelapsing-remitting multiple sclerosisPlacebo-controlled trialAcceptable safety profilePediatric age groupDisease-modifying therapiesPediatric MSGlatiramer acetateRelapse rateUnblinded trialSafety profileTreatment optionsDisease progressionExpert guidelinesAge groupsSclerosisTrialsCurrent knowledgeTreatmentInternational Pediatric MS Study Group Global Members Symposium report
Wassmer E, Chitnis T, Pohl D, Amato MP, Banwell B, Ghezzi A, Hintzen RQ, Krupp LB, Makhani N, Rostásy K, Tardieu M, Tenembaum S, Waldman A, Waubant E, Kornberg AJ. International Pediatric MS Study Group Global Members Symposium report. Neurology 2016, 87: s110-s116. PMID: 27572855, PMCID: PMC10688073, DOI: 10.1212/wnl.0000000000002880.Peer-Reviewed Original ResearchConceptsPediatric multiple sclerosisMultiple sclerosisInternational Pediatric Multiple Sclerosis Study GroupMultiple Sclerosis Study GroupOptimal vitamin D intakeEarly-onset multiple sclerosisNewer MS agentsAcute disseminated encephalomyelitisVitamin D intakeVitamin D deficiencyChildhood multiple sclerosisLong-term outcomesDrug treatment optionsDiverse patient samplesDifferentiation of MSEffective cognitive rehabilitationD intakeDisseminated encephalomyelitisD deficiencyNeuroinflammatory disordersNeuromyelitis opticaMS riskTreatment optionsMS outcomesClinical trialsOral Dimethyl Fumarate in Children With Multiple Sclerosis: A Dual-Center Study
Makhani N, Schreiner T. Oral Dimethyl Fumarate in Children With Multiple Sclerosis: A Dual-Center Study. Pediatric Neurology 2016, 57: 101-104. PMID: 26996405, DOI: 10.1016/j.pediatrneurol.2016.01.010.Peer-Reviewed Original ResearchConceptsOral dimethyl fumarateMultiple sclerosisDimethyl fumarateSide effectsFirst-line injectable therapiesBrain magnetic resonance imagingAbnormal liver transaminasesDual-Center ExperienceUsual adult doseMonths of therapyNew T2 lesionsFirst-line therapyCommon side effectsMagnetic resonance imaging (MRI) parametersPediatric multiple sclerosisDual-center studyChildren 18 yearsFormal clinical trialsMagnetic resonance imagingLiver transaminasesDisability scoresLaboratory abnormalitiesOral medicationsRelapse rateRetrospective review
2015
Viral exposures and MS outcome in a prospective cohort of children with acquired demyelination
Makhani N, Banwell B, Tellier R, Yea C, McGovern S, O’Mahony J, Ahorro JM, Arnold D, Sadovnick AD, Marrie RA, Bar-Or A, Network O. Viral exposures and MS outcome in a prospective cohort of children with acquired demyelination. Multiple Sclerosis Journal 2015, 22: 385-388. PMID: 26199356, DOI: 10.1177/1352458515595876.Peer-Reviewed Original ResearchMeSH KeywordsAntibodies, ViralChickenpoxChildCohort StudiesCytomegalovirus InfectionsDemyelinating DiseasesEnzyme-Linked Immunosorbent AssayEpstein-Barr Virus InfectionsFemaleHerpes SimplexHumansImmunoglobulin GMaleMultiple SclerosisProportional Hazards ModelsProspective StudiesSeroepidemiologic StudiesConceptsCMV infectionEpstein-Barr virus infectionRemote EBV infectionSubsequent MS diagnosisImportant prognostic informationMultiple sclerosis riskVaricella-zoster virusHerpes simplex virusCMV seroprevalenceDemyelinating syndromesMonophasic ADSEBV infectionCytomegalovirus infectionProspective cohortMS diagnosisViral exposurePrognostic informationMS outcomesVirus infectionHigh riskSimplex virusMS developmentInfectionProtective factorsChildren
2013
Diagnosing Neuromyelitis Optica
Makhani N, Bigi S, Banwell B, Shroff M. Diagnosing Neuromyelitis Optica. Neuroimaging Clinics Of North America 2013, 23: 279-291. PMID: 23608690, DOI: 10.1016/j.nic.2012.12.007.Peer-Reviewed Original ResearchConceptsNeuromyelitis opticaRecurrent optic neuritisInflammatory demyelinating disorderNMO spectrum disordersChildhood-onset diseaseBroad clinical spectrumAquaporin-4 expressionImportant therapeutic implicationsOptic neuritisTransverse myelitisDemyelinating disorderPrompt diagnosisMagnetic resonance imaging techniquesRecurrent attacksClinical spectrumBrain lesionsHigh riskTherapeutic implicationsAquaporin-4Severe disabilityDiagnostic accuracyOpticaDisordersSpectrum disorderImaging techniques
2011
Noninfectious Central Nervous System Inflammatory Disorders
Makhani N, Banwell B. Noninfectious Central Nervous System Inflammatory Disorders. Seminars In Pediatric Neurology 2011, 18: 91-94. PMID: 22036488, DOI: 10.1016/j.spen.2011.05.005.Peer-Reviewed Original ResearchConceptsInflammatory disordersAcute central nervous system inflammationCentral nervous system inflammatory disordersCentral nervous system inflammationNervous system inflammationCNS inflammatory diseasesChronic inflammatory disordersNeurology residency trainingCNS vasculitisMonophasic illnessSystem inflammationNeuromyelitis opticaMultiple sclerosisDiagnostic workupInflammatory diseasesFirst attackInitial assessmentResidency trainingDisordersVasculitisOpticaSclerosisInflammationIllnessWorkup
2010
A Twist on Lyme: the Challenge of Diagnosing European Lyme Neuroborreliosis
Makhani N, Morris SK, Page AV, Brophy J, Lindsay LR, Banwell BL, Richardson SE. A Twist on Lyme: the Challenge of Diagnosing European Lyme Neuroborreliosis. Journal Of Clinical Microbiology 2010, 49: 455-457. PMID: 21068272, PMCID: PMC3020460, DOI: 10.1128/jcm.01584-10.Peer-Reviewed Original Research
2009
Cyclophosphamide therapy in pediatric multiple sclerosisSYMBOLSYMBOL
Makhani N, Gorman MP, Branson HM, Stazzone L, Banwell BL, Chitnis T. Cyclophosphamide therapy in pediatric multiple sclerosisSYMBOLSYMBOL. Neurology 2009, 72: 2076-2082. PMID: 19439723, PMCID: PMC2923592, DOI: 10.1212/wnl.0b013e3181a8164c.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAge FactorsAge of OnsetChildCyclophosphamideDisease ProgressionDrug Administration ScheduleDrug ResistanceFemaleGlatiramer AcetateHumansImmunosuppression TherapyImmunosuppressive AgentsInterferon-betaMaleMitoxantroneMultiple SclerosisPeptidesRetrospective StudiesSecondary PreventionSex DistributionTreatment OutcomeConceptsMultiple sclerosisTreatment of childrenInduction therapyMaintenance therapyTreatment initiationDisability Status Scale scoreAggressive multiple sclerosisFirst-line therapyRetrospective chart reviewMajority of patientsStatus Scale scoreCyclophosphamide therapyChart reviewDisability scoresMost patientsMulticenter experienceMultiple relapsesRelapse ratePatient selectionTransient alopeciaBladder carcinomaTreatment administrationCyclophosphamideSide effectsScale score