Clinical Immunology

Last Minute Review

Neuroimmunology — Last Minute Review

A last-minute review of high-yield facts — dense tables and one-liners for RITE/Board prep. Not a substitute for the full notes.
McDonald Criteria (2024 Revision) — MS Diagnosis
Criterion2024 RequirementHow to Fulfill
DIS (Dissemination in Space)≥1 T2 lesion in ≥2 of 5 CNS regionsPeriventricular, cortical/juxtacortical, infratentorial, spinal cord, optic nerve (NEW) — need ≥2 of 5 areas
DIT (Dissemination in Time)No longer strictly required if other evidence supports MSDIT can be met by: new T2/Gd+ lesion on follow-up MRI, simultaneous Gd+ and non-enhancing lesions, or CSF OCBs/kappa free light chains
RIS (Radiologically Isolated Syndrome)Can now meet MS diagnostic criteria without clinical symptomsNEW: MRI findings consistent with DIS + supportive biomarkers (OCBs, central vein sign, paramagnetic rim lesions) — no clinical attack required

Key 2024 vs 2017 Changes

Feature2017 Criteria2024 Criteria
DIS regions4 regions (periventricular, cortical/juxtacortical, infratentorial, spinal cord)5 regions — optic nerve added as 5th location (via MRI orbits, OCT, or VEP)
DIT requirementStrictly required for diagnosisRemoved as strict requirement — diagnosis possible after single event if other evidence supports
New biomarkersOCBs onlyOCBs + central vein sign, paramagnetic rim lesions, kappa free light chains (CSF)
RISNot diagnostic — must await symptomsCan qualify for MS diagnosis if DIS + supportive biomarkers
Special populationsLimited guidanceSpecific guidance for children and adults ≥50 years
CIS categoryCIS = first event, not yet MSMany former CIS cases now diagnosable as MS at first presentation
DIS Region (5 total)Evidence
Periventricular≥1 T2 lesion (changed from ≥3 in 2017)
Cortical/juxtacortical≥1 lesion
Infratentorial≥1 lesion
Spinal cord≥1 lesion
Optic nerve (NEW)MRI optic nerve lesion, abnormal OCT (RNFL thinning), or abnormal VEP
💎 Board Pearl
The 3 biggest 2024 updates: (1) Optic nerve = 5th DIS region (use MRI orbits, OCT, or VEP), (2) DIT no longer strictly required — diagnosis possible at first presentation, (3) RIS can now = MS with supportive biomarkers. New supportive biomarkers: central vein sign (≥40% of lesions), paramagnetic rim lesions, and CSF kappa free light chains. Periventricular lesion threshold reduced from ≥3 to ≥1.
MS vs NMOSD vs MOGAD
FeatureMSNMOSD (AQP4+)MOGAD
AntibodyNone specific (OCBs in CSF)AQP4-IgG (serum; ~80% sensitivity)MOG-IgG (serum; CBA preferred)
Sex ratio (F:M)~3:1~9:1~1:1
Age at onset20–4030–50Bimodal: children + young adults
ON featuresUnilateral, mild, retrobulbar, good recoverySevere, often bilateral, posterior > anterior, poor recoveryBilateral, anterior predominant, disc edema, perineural enhancement, good recovery
MyelitisShort segment (<3 vertebral segments), peripheralLETM (≥3 segments), central gray matter, bright spotty lesionsLETM, conus/lower cord predilection
Brain MRIDawson fingers, periventricular ovoid lesions perpendicular to ventriclesOften normal early; area postrema, periaqueductal, diencephalic, cloud-like enhancementFluffy bilateral cortical/deep WM, ADEM-like in children
Spinal MRIShort lesions, dorsolateral, incomplete ring enhancementLETM (≥3 segments), central cord, may enhance diffuselyLETM, conus involvement, can mimic NMOSD
CSF OCBsPresent >95%Usually absent (~15–20%)Usually absent
Relapse patternRelapses then progressive phase (SPMS)Relapsing >90%; rarely monophasic~50% monophasic, ~50% relapsing
Acute treatmentIV methylprednisoloneIV methylprednisolone + early PLEXIV methylprednisolone (very steroid-responsive); PLEX if refractory
Maintenance treatmentDMTs (interferons, anti-CD20, S1P modulators, etc.)Rituximab, eculizumab, satralizumab, inebilizumab, azathioprine, mycophenolateNo FDA-approved DMT; azathioprine, mycophenolate, rituximab if relapsing
MS DMTs harmful?YES — interferons, fingolimod, natalizumab worsen NMOSDLikely — interferons, fingolimod should be avoided
PrognosisVariable; disability accrues over decadesPoor recovery per attack; cumulative disability from relapsesGenerally good recovery per attack; better than NMOSD
Clinical Pearl
Do NOT treat NMOSD with MS DMTs — interferon-β, fingolimod, and natalizumab can worsen NMOSD attacks. Always confirm AQP4 status before starting MS-specific DMTs in patients with LETM or severe/bilateral ON.
💎 Board Pearl
Area postrema syndrome (intractable nausea/vomiting/hiccups) is nearly pathognomonic for NMOSD. MOG-IgG titers can become negative over time — persistent positivity predicts relapsing course. MOGAD optic neuritis shows characteristic perineural enhancement (around the nerve sheath, not just the nerve). NMOSD bright spotty lesions on T2 = high specificity.
MS Disease-Modifying Therapies
DMTRouteMOAMonitoringKey RiskEfficacy Tier
Interferon-βIM/SC (varies by formulation)Immunomodulatory, ↓ BBB disruptionCBC, LFTs q3–6moFlu-like symptoms, hepatotoxicity, depressionModerate
Glatiramer acetateSC daily or 3×/weekMBP mimic → Th2 shiftNone requiredInjection site reactions, lipoatrophy, post-injection reactionModerate
TeriflunomidePO dailyDHODH inhibitor → ↓ pyrimidine synthesisLFTs monthly ×6mo then q6mo; TB test before startTeratogenic (Category X); hepatotoxicity; hair thinningModerate
Dimethyl fumaratePO BIDNrf2 pathway activationCBC q6mo (lymphocytes!)Lymphopenia → PML; GI; flushingModerate
FingolimodPO dailyS1P modulator → lymphocyte sequestration in LNFirst-dose 6hr cardiac monitoring; ophthalmology 3–4mo; CBC; LFTsBradycardia/AV block (first dose); macular edema; PML; VZV; reboundHigh
SiponimodPO daily (dose titration)S1P1/S1P5 selectiveCYP2C9 genotype before start; cardiac monitoring; ophthalmologyBradycardia; macular edema; *3/*3 genotype = contraindicatedHigh (approved for active SPMS)
OzanimodPO daily (7-day titration)S1P1/S1P5 selectiveCBC, LFTs, ECG, ophthalmologyBradycardia; macular edema; avoid with MAOIsHigh
CladribinePO short courses (Year 1 + Year 2 only)Purine analog → selective lymphocyte depletionCBC before each courseLymphopenia; infections; malignancy concernHigh (immune reconstitution)
NatalizumabIV q4 weeksAnti-α4-integrin → blocks lymphocyte CNS entryJCV Ab q6mo; MRI q3–6moPML (JCV+, prior IS, >2 years)High
OcrelizumabIV q6 monthsAnti-CD20 (humanized) → B-cell depletionHep B screen; IgG levels; CBCInfusion reactions; infections; breast cancer signalHigh (first PPMS approval)
OfatumumabSC monthly (after loading)Anti-CD20 (fully human)Hep B screen; IgG levelsInjection reactions; infections; ↓ immunoglobulinsHigh
AlemtuzumabIV ×5d (year 1), ×3d (year 2)Anti-CD52 → profound lymphocyte depletionCBC + TFTs monthly ×4 years after last dose; urinalysis monthly; skin examsSecondary autoimmunity (thyroid 40%, ITP, anti-GBM); stroke; MIHigh (REMS program)
MitoxantroneIV q3 months (lifetime dose limit)Topoisomerase II inhibitor → immunosuppressionCardiac echo before and during; CBCCardiotoxicity (cumulative dose limit 140 mg/m²); AML riskHigh (rarely used now)

PML Risk Stratification (Natalizumab)

Risk FactorDetail
JCV antibody statusNegative = very low risk (~0.1/1000); positive = stratify further
JCV antibody index>1.5 = significantly higher risk; ≤0.9 = lower risk among JCV+ patients
Prior immunosuppression↑↑ risk if prior azathioprine, MTX, mitoxantrone, cyclophosphamide
Natalizumab durationRisk ↑ after 24 months; highest at 24–72 months
Highest risk groupJCV Ab+ with index >1.5 + prior IS + >2 years → ~13/1000
Extended interval dosingQ6–8 week dosing may ↓ PML risk (observational data)
💎 Board Pearl
JCV risk trifecta: anti-JCV Ab index >1.5, prior immunosuppression, natalizumab >2 years. S1P first-dose cardiac monitoring: required for fingolimod (6 hrs) and siponimod; ozanimod/ponesimod use gradual titration instead. Glatiramer = safest in pregnancy (Category B). Teriflunomide = Category X, requires cholestyramine washout. Anti-CD20 agents do NOT deplete plasma cells (CD20−). Alemtuzumab monitoring continues 4 years after LAST dose. Rebound risk: S1P modulators and natalizumab carry high rebound if stopped without bridging. DMF PML: occurs with ALC <500 for >6 months — stop drug.
Acute Relapse Treatment Protocol
StepTreatmentDoseDurationNotes
First-lineIV Methylprednisolone1 g IV daily3–5 daysSpeeds recovery but does NOT change long-term disability in MS; consider oral taper; very steroid-responsive in MOGAD
Second-linePLEX (Plasma Exchange)5–7 exchangesOver 10–14 daysStart early for best response; especially effective in NMOSD and severe MS relapses refractory to steroids
Alternative second-lineIVIg2 g/kg totalOver 2–5 daysUsed when PLEX unavailable; check IgA deficiency before first infusion (anaphylaxis risk)
Rescue / refractoryRituximab1000 mg IV ×2 (days 0, 14)Effect in weeksFor autoimmune encephalitis, refractory NMOSD, aggressive MS; Hep B screening mandatory
Rescue / refractoryCyclophosphamide500–1000 mg/m² IVMonthly pulsesFor PACNS induction, refractory autoimmune encephalitis, severe SLE; give MESNA for bladder protection
💎 Board Pearl
PLEX is most effective for NMOSD relapses and severe MS relapses refractory to steroids — start early (within days), delays significantly reduce efficacy. NMOSD FDA-approved maintenance therapies (AQP4+): eculizumab, satralizumab, inebilizumab — all require AQP4-IgG positivity. Eculizumab: meningococcal vaccination at least 2 weeks before first dose. Check TPMT before azathioprine; check IgA before IVIg.
Autoimmune Encephalitis — Antibody Table
AntibodyTargetKey SyndromeAssociated TumorAge/SexTreatment Response
Anti-NMDARNR1 subunit (cell-surface)Psychiatric → seizures → dyskinesias → autonomic instability → central hypoventilationOvarian teratoma (young women)Young women; F>>MExcellent if treated early + tumor removal
Anti-LGI1LGI1 (cell-surface)Limbic encephalitis: memory loss, confusion, temporal seizures, hyponatremia (SIADH)Rare (<10%)Older men (50–70)Good; responds to immunotherapy
Anti-CASPR2CASPR2 (cell-surface)Morvan syndrome (encephalitis + peripheral nerve hyperexcitability + autonomic dysfunction + insomnia)Thymoma (~20%)Older menGood; may need prolonged therapy
Anti-GABABGABA-B receptor (cell-surface)Limbic encephalitis with prominent, refractory seizuresSCLC (~50%)Older adultsModerate; tumor treatment critical
Anti-AMPARAMPA receptor (cell-surface)Limbic encephalitis; frequent relapsesLung, breast, thymoma (~65%)Older womenGood; high relapse rate
Anti-DPPXDPPX (cell-surface)Prodromal severe diarrhea/weight loss → encephalitis + hyperekplexiaRareAdultsGood
Anti-IgLON5IgLON5 (cell-surface)NREM/REM parasomnia + bulbar dysfunction + gait instability; tauopathy on pathologyNoneOlder adults; HLA-DRB1*10:01Poor; progressive despite therapy
Anti-GlyRGlycine receptor (cell-surface)PERM (progressive encephalomyelitis with rigidity and myoclonus); stiff-person spectrumRareAdultsBetter than anti-GAD SPS
💎 Board Pearl
Faciobrachial dystonic seizures (FBDS) = pathognomonic for anti-LGI1 — brief, frequent, AED-resistant, immunotherapy-responsive. Treat early to prevent cognitive decline. Extreme delta brush on EEG (rhythmic delta + superimposed beta) = anti-NMDAR encephalitis. Anti-NMDAR encephalitis can follow HSV encephalitis (post-infectious autoimmune mechanism). Hyponatremia + limbic encephalitis = think LGI1. CSF antibody more sensitive than serum for NMDAR; serum more sensitive for LGI1.
Paraneoplastic Antibodies — Intracellular (Poor Prognosis)
AntibodySyndromeAssociated TumorResponse to Immunotherapy
Anti-Hu (ANNA-1)Sensory neuropathy, encephalomyelitis, limbic encephalitis, autonomic neuropathySCLCPoor — most common paraneoplastic Ab; multifocal dysfunction
Anti-Yo (PCA-1)Subacute pancerebellar degeneration (irreversible Purkinje cell loss)Ovarian, breastPoor — essentially irreversible once established; treat tumor first
Anti-Ri (ANNA-2)Opsoclonus-myoclonus-ataxia, brainstem encephalitisBreast, SCLCPartial — may improve with tumor treatment
Anti-CV2 (CRMP5)Chorea + peripheral neuropathy, optic neuritis, uveitisSCLC, thymomaPoor — chorea + neuropathy combo is characteristic
Anti-amphiphysinStiff-person syndrome, encephalomyelitisBreast, SCLCPoor — paraneoplastic SPS variant (vs anti-GAD65 SPS)
Anti-Ma2 (Ta)Limbic/diencephalic encephalitis, narcolepsy, vertical gaze palsyTesticular germ cell (young men); lung (older)Moderate — better prognosis if testicular tumor (curable)
Anti-SOX1Lambert-Eaton myasthenic syndrome, cerebellar ataxiaSCLCPoor — often co-occurs with anti-VGCC; supports SCLC association
Anti-GAD65Stiff-person syndrome, cerebellar ataxia, temporal lobe epilepsyRarely paraneoplastic (thymoma, SCLC if tumor); usually autoimmuneVariable — very high titers (>10,000) = neurological; low titers = type 1 DM
Clinical Pearl
Intracellular antibodies (Hu, Yo, Ri, CV2, amphiphysin, Ma2) = T-cell mediated neuronal destruction = poor response to immunotherapy = FIND AND TREAT THE TUMOR. Cell-surface antibodies (NMDAR, LGI1, CASPR2, AMPAR, GABA-B, VGCC) = antibody-mediated = potentially reversible with immunotherapy + tumor removal.
💎 Board Pearl
Young man + limbic encephalitis + hypersomnia + vertical gaze palsy = anti-Ma2 → check for testicular tumor. Opsoclonus-myoclonus in adults = anti-Ri or lung cancer; in children = neuroblastoma. LEMS: anti-VGCC (P/Q-type), SCLC ~60%, proximal weakness + areflexia + facilitation on high-frequency rNS, treat with 3,4-DAP. Neurological symptoms often PRECEDE cancer diagnosis by months to years.
Systemic Autoimmune Diseases — Neuro Manifestations
DiseaseCNS FeaturesPNS FeaturesKey TestTreatment
NeurosarcoidosisCN VII palsy (most common CN), leptomeningeal enhancement, hypothalamic/pituitary lesions (DI), chronic meningitis, myelopathy (dorsal subpial)Small fiber neuropathy (most common PNS), mononeuritis multiplexChest CT (bilateral hilar LAD); ACE (low sensitivity ~60%); non-caseating granulomas on biopsy; PET-CT for biopsy targetsSteroids → MTX/AZA/MMF → infliximab (refractory)
Neuro-BehçetBrainstem/diencephalic encephalitis, cerebral venous sinus thrombosis, cranial neuropathiesRareClinical criteria (oral ulcers + 2 of: genital ulcers, eye lesions, skin lesions, pathergy); HLA-B51Steroids + azathioprine; anti-TNF for refractory; anticoagulation for CVST
SLE (neuropsychiatric)Psychosis, seizures, cognitive dysfunction, stroke (antiphospholipid), transverse myelitis, chorea, aseptic meningitisPeripheral neuropathy, cranial neuropathiesANA, anti-dsDNA; antiphospholipid antibodies (anticardiolipin, β2-GP1, lupus anticoagulant)Steroids + cyclophosphamide (severe); anticoagulation for APS
Sjögren syndromeMyelitis (can mimic NMOSD — check AQP4), cognitive dysfunction, CNS lymphoma riskSensory neuropathy (small fiber or sensory ganglionopathy), trigeminal neuropathyAnti-SSA (Ro), anti-SSB (La); lip biopsy; Schirmer testSteroids, rituximab; treat neuropathy symptomatically
IgG4-related diseaseOrbital pseudotumor (most common neuro), hypertrophic pachymeningitis, hypophysitis, perineural diseaseCranial nerve palsies↑ Serum IgG4; biopsy: storiform fibrosis, >10 IgG4+ plasma cells/HPFSteroids (very responsive); rituximab for refractory
💎 Board Pearl
Neurosarcoidosis: facial nerve palsy is the most common cranial neuropathy; can be bilateral. Serum ACE is neither sensitive nor specific — do not use to rule in or out. Non-caseating granulomas = gold standard finding. Infliximab (NOT etanercept) for refractory neurosarcoidosis — etanercept can paradoxically worsen sarcoidosis. Bilateral facial palsy differential: sarcoidosis, Lyme, GBS, HIV, lymphoma.
CNS Vasculitis — PACNS vs RCVS vs Susac
FeaturePACNSRCVSSusac Syndrome
PresentationInsidious: headache, cognitive decline, strokes in multiple territoriesAcute: recurrent thunderclap headaches over days to weeksSubacute: encephalopathy + vision loss + hearing loss
Headache patternChronic, progressive, dullThunderclap (<60 seconds to peak); recurrent; often triggered by Valsalva, exertion, sexVariable; may be mild or absent
ImagingMultifocal infarcts in different vascular territories; white matter lesions; mass-like lesions possibleConvexity SAH; posterior predominant edema (like PRES); infarcts if severeSnowball lesions in CENTRAL corpus callosum (pathognomonic); periventricular white matter lesions
AngiographyBeading/stenosis (~60% sensitivity); can be normal (small vessel)Diffuse segmental vasoconstriction (beading); REVERSIBLE within 12 weeksBranch retinal artery occlusions on fluorescein angiography
CSFElevated protein, pleocytosis in ~90%; ESR/CRP often NORMALUsually NORMALElevated protein, mild pleocytosis possible
BiopsyGold standard (leptomeninges + cortex); 25% false-negative rateNot indicatedNot indicated
TreatmentCyclophosphamide + corticosteroids induction; AZA/MMF maintenanceCalcium channel blockers (nimodipine/verapamil); remove triggers; NO immunosuppressionAggressive: IVMP + IVIg + PLEX; MMF/AZA maintenance; antiplatelet
PrognosisChronic, relapsing; can be fatal without treatmentSelf-limited (resolves in 1–3 months); generally goodVariable; early aggressive treatment improves outcomes
💎 Board Pearl
RCVS = thunderclap headache + reversible vasoconstriction (resolves in 3 months); triggers include triptans, SSRIs, cannabis, postpartum. Do NOT immunosuppress RCVS — it is NOT a vasculitis. Susac = encephalopathy + BRAO + sensorineural hearing loss (clinical triad). Susac snowball lesions are in the CENTRAL corpus callosum; MS lesions are at the callosal-septal interface (Dawson fingers). PACNS brain biopsy: need leptomeninges + cortex in sample; 25% false-negative rate.
Other Neuroimmunology Conditions
ConditionKey FeaturesDiagnosisTreatment
ADEMMonophasic; children >> adults; post-infectious/post-vaccination; encephalopathy REQUIRED; large fluffy bilateral WM lesions + deep gray matter (thalamus)Clinical: polyfocal deficits + encephalopathy + large lesions; MOG-IgG positive in many pediatric cases; OCBs usually absentIV methylprednisolone → PO taper; IVIg or PLEX if refractory
Transverse myelitisAcute/subacute bilateral motor + sensory + autonomic spinal cord dysfunction; sensory level; urinary retentionSpinal MRI (T2 hyperintensity ≥2 segments for idiopathic); CSF pleocytosis; rule out compressive, NMOSD, MS, MOGIV methylprednisolone; PLEX if refractory; address underlying cause
NMOSD-associated ONSevere, often bilateral; posterior > anterior; poor recovery; chiasmal involvement; AQP4+AQP4-IgG serum; MRI orbits (long-segment enhancement, often posterior/chiasmal)IV methylprednisolone + early PLEX; long-term: rituximab/eculizumab/satralizumab/inebilizumab
Stiff-person syndromeProgressive axial rigidity + painful spasms (triggered by startle/emotion); exaggerated lumbar lordosis; anti-GAD65 (very high titers >10,000)Anti-GAD65 (high titer); anti-amphiphysin (if paraneoplastic → breast/SCLC); EMG: continuous motor unit activity at restDiazepam/baclofen (symptomatic); IVIg (immunotherapy of choice); rituximab; tumor treatment if paraneoplastic
Hashimoto encephalopathy (SREAT)Subacute encephalopathy (cognitive decline, seizures, myoclonus, stroke-like episodes); anti-TPO/anti-TG antibodies; DRAMATICALLY steroid-responsiveDiagnosis of exclusion; elevated anti-TPO/anti-TG; EEG: diffuse slowing; CSF: elevated protein; normal thyroid function oftenHigh-dose corticosteroids (dramatic response = diagnostic clue); steroid-sparing agents if relapsing
Immune checkpoint neurotoxicityAnti-PD-1/PD-L1/CTLA-4 therapy; myasthenia gravis (most common NMJ), GBS, encephalitis, myositis, aseptic meningitis, transverse myelitis; can overlap (myasthenia + myositis + myocarditis)Temporal relationship to checkpoint inhibitor; antibody testing; EMG/NCS; MRIHold checkpoint inhibitor; high-dose steroids; IVIg or PLEX for severe; permanent discontinuation for grade 3–4
CLIPPERSChronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids; ataxia, diplopia, dysarthria; punctate/curvilinear Gd-enhancing lesions in pons → "peppering" patternMRI: punctate gadolinium-enhancing lesions centered on pons; biopsy: perivascular T-cell infiltration; exclude lymphomaCorticosteroids (dramatic response); steroid-sparing (MTX, MMF); relapses on taper common
Bickerstaff brainstem encephalitisOphthalmoplegia + ataxia + encephalopathy (altered consciousness); overlap with GBS and Miller Fisher; anti-GQ1b antibodiesAnti-GQ1b (positive in ~65%); CSF albuminocytologic dissociation; MRI brainstem lesions possible; EEG: diffuse slowingIVIg or PLEX (as for GBS); generally good prognosis
Clinical Pearl
ADEM = monophasic, children, post-infectious, large fluffy lesions, encephalopathy REQUIRED for diagnosis. If "ADEM" recurs, think MOGAD or MS. Multiphasic ADEM = second event ≥3 months after first; if ≥2 non-ADEM events → likely MOGAD or MS. SREAT (Hashimoto encephalopathy) is a diagnosis of exclusion — the dramatic steroid response is the diagnostic clue. Checkpoint inhibitor neurotoxicity: watch for MG + myositis + myocarditis overlap (can be fatal).
Key Numbers & Board Traps
FactValue / Detail
McDonald DIS requirement≥1 T2 lesion in ≥2 of 4 regions (periventricular, cortical/juxtacortical, infratentorial, spinal)
OCB bands needed≥2 CSF-specific oligoclonal bands (not matched in serum)
MS relapse definitionSymptoms lasting ≥24 hours, occurring ≥30 days after previous attack, not explained by fever/infection
JCV index thresholdAnti-JCV Ab index >1.5 = high PML risk on natalizumab
Natalizumab PML risk factorsJCV Ab+ (index >1.5) + prior immunosuppression + duration >2 years → ~13/1000
NMOSD LETM definition≥3 contiguous vertebral segments of T2 signal on spinal MRI
AQP4-IgG sensitivity in NMOSD~80% by cell-based assay; lower by ELISA (~70%); seronegative NMOSD exists
NMDAR encephalitis F:M ratio~4:1 overall; higher in teratoma-associated (nearly all female)
Rituximab redosing intervalEvery 6 months; monitor CD19/CD20 counts for B-cell reconstitution
MS pregnancy relapse patternRelapses ↓ in 3rd trimester; ↑↑ rebound in first 3 months postpartum
Fingolimod first-dose monitoring6-hour continuous cardiac monitoring (ECG + BP); risk of bradycardia/AV block; do not use if resting HR <55
Siponimod CYP2C9 genotyping*3/*3 = contraindicated; required before starting
Alemtuzumab monitoring durationMonthly CBC + TFTs + urinalysis for 4 years after LAST dose
Teriflunomide washoutCholestyramine 8 g TID ×11 days; confirm levels <0.02 mg/L ×2 (two weeks apart) before conception
DMF ALC threshold for PMLStop if ALC <500 for >6 months
Anti-GAD65 titer thresholdLow (<20) = type 1 DM; very high (>10,000) = neurological (SPS, ataxia, epilepsy)
PPMS progression requirement≥1 year of progressive disability (not a single time point)
CIS conversion risk with OCBsOCBs + ≥2 T2 lesions = ~90% convert to MS within 20 years
Eculizumab meningococcal vaccineMust vaccinate ≥2 weeks before first dose; if urgent, start antibiotics until 2 weeks post-vaccine
PACNS biopsy false-negative rate~25% (sampling error); need leptomeninges + cortex in specimen
RCVS resolutionVasoconstriction resolves within 1–3 months (by definition)
💎 Board Pearl
NMOSD + MS DMTs = disaster (interferons, fingolimod, natalizumab can worsen NMOSD). PML is not just natalizumab (also DMF, fingolimod, rituximab). FBDS are NOT epilepsy — they respond to immunotherapy, not AEDs. Etanercept can paradoxically worsen sarcoidosis (use infliximab). GCA + vision loss = start steroids BEFORE biopsy. Anti-NMDAR encephalitis can follow HSV encephalitis. Teriflunomide + pregnancy = cholestyramine washout required. IVIg + IgA deficiency = anaphylaxis risk. ADEM requires encephalopathy — if absent, it is not ADEM.