الفهرس 
GAIT AFFECTION IN MULTIPLE SCLEROSISOnly 14 pages are availabe for public view
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Abstract
Background: Multiple sclerosis (MS) is one of the most common disabling diseases of the Central Nervous System (CNS) especially during early adult life. Walking impairment is considered one of the most disabling symptoms to patient with MS. The only approved treatment for impaired ambulation in MS is Dalfampridine.
Objective: To investigate the effect of dalfampridine on gait impairment, cognitive functions and fatigue in sample of Egyptian patients with multiple sclerosis.
Methods: This randomized double blinded placebo-controlled study was conducted on 100 patients with relapsing remittent multiple sclerosis attending to MS outpatient clinic in Ain Shams University hospital and Dar Alshefa Hospital, they were located in Eastern Cairo and serves large sector of ministry of health patients in Greater Cairo, collected in a period starting from May 2021 till June 2023.
Results: Baseline characteristics of dalfampridine group significantly showed more infratentorial lesions in MRI and lesser use of symptomatic treatment compared to placebo group. Along with visuospatial functions that was better in placebo group and even though this current study showed significant improvement in dalfampridine group better than placebo as concluded by increased endpoint (mean difference) between two groups. These observations highlight the powerful of our results. In addition to that, what weaken the placebo effect that shown in some functions, the low lesion load of radiological findings in significant way as compared to dalfampridine group.
Conclusions: The current study demonstrated the positive effect of dalfampridine in walking speed, balance and ambulatory disability. It investigated the therapeutic value of dalfampridine in fatigue 3 domains. Remarkably it highlighted the beneficial effect of dalfampridine on cognitive impairment especially; processing speed, auditory-verbal memory, visuospatial abilities, abstraction and delayed recall. Moreover, this study showed fair safety profile of fampridine, with mild side effects. However further RCT with large number and longer duration are warranted to confirm the beneficial effect of dalfampridine in long-term use.