Multiple sclerosis presented as clinically isolated syndrome: the need for early diagnosis and treatment

Sigliti-Henrietta Pelidou, Sotirios Giannopoulos, Sotiria Tzavidi, Georgios Lagos, Athanassios P KyritsisDepartment of Neurology, University of Ioannina School of Medicine, GreeceObjective: To aid in the timely diagnosis of patients who present with clinically isolated syndrome (CIS).Patients and methods: We studied 25 patients (18 women, 7 men), originally presented in our clinic with a CIS suggestive of multiple sclerosis (MS). All patients underwent the full investigation procedure including routine tests, serology, cerebrospinal fluid (CSF) examinations, evoked potentials (EPs), and magnetic resonance imaging (MRI) of brain and cervical spinal cord. Patients were imaged at baseline, and every three months thereafter up to a year.Results: The CIS was consisted of optic neuritis in 12 cases, incomplete transverse myelitis (ITM) in 7 cases, Lhermitte sign in 2 cases, internuclear ophthalmoplegia (INO) in 2 cases, mild brainstem syndrome in 1 case, and tonic-clonic seizures in 1 case. Using the baseline and three-month scans 18/25 (72%) patients developed definite MS in one year of follow up while 7 (28%) had no further findings during this observation period. Immunomodulatory treatments were applied to all definite MS patients.Conclusion: In light of new treatments available, MRIs at 3 month intervals are helpful to obtain the definite diagnosis of MS as early as possible.Keywords: multiple sclerosis, clinically isolated syndrome, optic neuritis, transverse myeliti

Characteristics of the urban heat island effect, in the coastal city of Patras, Greece

The ambient air urban heat island effect (at a height of 4÷4.5 m) is studied in the coastal city of Patras. For this purpose, 11 fixed temperature stations have been placed in chosen representative locations to monitor the ambient air temperature variations. Temperature stations are placed in urban places: at the center of the city (intense traffic), around the center (moderate traffic), and in a rural region outside the town (at ∼10 km). Collected data for June, July, August and September 2018 are examined statistically and results are extracted indicating that urban heat island effects are not very intense. An analysis of air temperatures in transverse and longitudinal to sea-line streets has shown some lower air temperatures across transversal streets

Status epilepticus in scleromyxedema

Scleromyxedema is a rare dermatologic disorder, characterized by erythematous or yellowish lichenoid waxy papules. Neurological manifestations are rare but well-recognized. A 51-year-old woman, diagnosed with scleromyxedema, was admitted to the hospital with status epilepticus, caused by brain lesions, as disclosed in a brain magnetic resonance imaging (MRI). The patient was treated with anticonvulsants and corticosteroids and gradually recovered fully. A complete remission of the lesions was shown in a follow-up brain MRI. In cases with scleromyxedema and the presence of neurological manifestations, we need to pay attention to central nervous system involvement, especially when combined with brain MRI lesions, and treat the patient appropriately