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Paraskevas et al. Neuroimmunol Neuroinflammation 2018;5:49 I http://dx.doi.org/10.20517/2347-8659.2018.50 Page 5 of 6

condition). This co-occurrence may be incidental and the two disorders may progress in parallel, but un-
related to each other. Alternatively, the two disorders, once incidentally coexistent, may interact with each
other, modulating the pathophysiological mechanisms and phenotypes. A third possibility is that CADASIL
through various mechanisms may trigger autoimmune reactions, and either be complicated by an inflam-
matory component (“inflammatory form of CADASIL”) or cause an MS-like disorder.

Mistreating CADASIL with immunomodulating treatments targeting MS should be avoided. However, the
rare CADASIL patient with an inflammatory component should not be denied the use of immunological
treatments.

DECLARATIONS
Authors’ contributions
Concept and definition of intellectual content: Paraskevas GP, Kapaki E
Literature search: Paraskevas GP, Constantinides VC
Manuscript preparation: Paraskevas GP, Constantinides VC
Manuscript editing and manuscript review: Kapaki E

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declare no conflicts of interest.

Ethics approval and patient consent
This review is part of the study named “Migraine and Specific Vasculopathies Registry” of the 1st Depart-
ment of Neurology, National and Kapodistrian University of Athens, which has been approved by the Scien-
tific and Ethics Committee of Eginition Hospital and is not supported by any funding. The patients whose
MRIs are shown in Figure 1, gave informed consent for inclusion in the study and publication of their MRI
images.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2018.

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