BACKGROUND: The @entity972 channel blockers @entity973 (AP) and @entity5129 ( @entity6136 ) increase nerve conduction in demyelinated nerve fibers, and have been proposed as a symptomatic therapy for @entity1 with @entity15 ( @entity15 ). OBJECTIVES: To determine the efficacy and safety of @entity38146 for @entity51 in @entity15 @entity1 . SEARCH STRATEGY: We searched CENTRAL (Issue 2, 2002), MEDLINE (January 1966-July 2002), EMBASE (1974-July 2002), and the Cochrane @entity15 Group's Specialised Register. We hand searched bibliographic references from retrieved studies and recent @entity15 symposia reports, and contacted known studies' investigators. SELECTION CRITERIA: We included trials fulfilling all following criteria: @entity23 ( @entity23 ); adults with @entity15 , out of exacerbation; AP or @entity6136 treatment versus placebo; clinical endpoints. DATA COLLECTION AND ANALYSIS: We identified 26 potentially pertinent studies. Three reviewers independently extracted data and assessed trial quality from 17 full-paper studies. MAIN RESULTS: Six studies (eight publications, 198 @entity1 , all crossover trials) were considered. Five studies assessed the efficacy of AP versus placebo, one compared @entity6136 with active placebo. Treatment duration ranged from hours to six months. Median quality score of the studies was 3. Heterogeneity of outcome assessment and absence of information on individual study periods allowed quantitative pooling of results for few categorical variables. Of the 198 treated @entity1 , there were six major side effects: one acute @entity75 , three episodes of @entity911 , and two @entity410 . Three studies (54 @entity1 ) assessed manual muscle testing, with 29 @entity1 (54%) improving in at least one muscular district during study treatment versus four @entity1 (7%) during placebo (odds ratio [OR] 14.5, 95% confidence interval [CI] 4.7-43.7). Nine out of 54 @entity1 (17%) improved in ambulation during study treatment versus none during placebo (p<0.001). A lower EDSS score was found in 13/198 @entity1 during study treatment (7%) versus none during placebo (p<0.001). No improvement in neuropsychological tests was found in three trials assessing cognitive function. Finally, 47/136 @entity15 @entity1 (35%) felt better when receiving the study drug, against 7(5%) on placebo (OR 9.7, 95% CI 4.3-22.0). REVIEWER'S CONCLUSIONS: Currently available information allows no unbiased statement about safety or efficacy of @entity38146 for treating @entity15 symptoms. Furthermore, we could not obtain any data on three unpublished @entity23 (more than 300 @entity1 ). We conclude that publication bias remains a pervasive problem in this area, and that until the results of these unpublished studies are available to the scientific community, no confident estimate of effectiveness of @entity38146 in the management of @entity15 symptoms is possible.

@entity38146 for symptomatic treatment in XXXX .

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'people'] @entity6136 :: ('CHEBI:18383', 'Chemical') :: ['DAP'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizures'] @entity75 :: ('MESH:D001927', 'Disease') :: ['encephalopathy'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficits'] @entity38146 :: ('MESH:D000631', 'Chemical') :: ['aminopyridines'] @entity23 :: ('MESH:D007174', 'Disease') :: ['randomised controlled trials', 'RCTs'] @entity911 :: ('MESH:D003221', 'Disease') :: ['confusion'] @entity5129 :: ('MESH:C016361', 'Chemical') :: ['3,4-diaminopyridine'] @entity972 :: ('MESH:D011188', 'Chemical') :: ['potassium'] @entity973 :: ('MESH:D015761', 'Chemical') :: ['4-aminopyridine'] @entity15 :: ('MESH:D009103', 'Disease') :: ['multiple sclerosis', 'MS']
@entity15 :: (MESH:D009103,Disease) :: ['multiple sclerosis']
