Preventive Neurology

I have almost completed a paper with a colleague and friend Viqar Chamoun. He was a contemporary of mine when I did my PhD. Chamoun and I worked in the same laboratory and we spent many hours chewing the cud together. Chamoun is a very deep thinker and got me interested in medical philosophy and the application of logic to defining a disease. Chamoun worked on neurosarcoidosis and developed a set of logical steps to show that contemporary diagnostic criteria for neurosarcoidosis were based on tautology. Despite his logical approach we never got his seminal paper published. The plan is to publish it now and in parallel with a paper defining MS as a biological disease and setting-out the principles of how we should incorporate biomarkers into the diagnostic criteria to improve both the sensitivity and specificity of the current criteria. Viqar Chamoun - thinker extraordinaire   Surprise, surprise one of the biomarkers we want to explore is EBV seropositivity. However, to validate a n...

"Professor Giovannoni, you tell me that my daughter has a 1 in 40 chance of developing multiple sclerosis and that MS has reached epidemic proportions in parts of the world? Is there anything I can do to reduce her chances of getting MS? Is there anything we can do to stop other people from getting MS?" Although multiple sclerosis (MS) is a complex disease due to the interaction of genetic and environmental factors data on the occurrence of MS at the population level (epidemiology) supports the Epstein Barr Virus (EBV) as being necessary, but not sufficient, for someone to develop MS. In other words, EBV is probably the cause of MS. Of all the putative causative agents that have been proposed to be associated with MS, EBV is the only one where the risk of getting MS if you are EBV negative is close to zero or zero if you limit the analyses to those studies which use a technique called immunofluorescence microscopy as the gold-standard assay to detect anti-EBV antibodies. EBV ...