Neuromyelitis Optica: Case Report

OBJECTIVES: Neuromyelitis optica (Devic’s syndrome) is an uncommon but severe form of demyelinating disease. This syndrome is characterized by acute or relapsing inflammatory demyelination restricted to the optic nerves and spinal cord. We present a patient with monophacic Devic’s syndrome according to Dean Wingerchuk and et al. diagnostic criteria (2006). MATERIAL-METHODS: A 26-year-old woman was admitted in our hospital with acute visual lost and tetraplegia. There were demyelination in MRI that involved cervicomeduller junction to thoracal 5 level and bilateral optic nerves. The cerebrospinal fluid included mild pleocytosis and raised protein level. Oligoclonal band was absent. In the blood examinations, immunological and enfectious markers was negative. RESULTS: The patient had been treated with corticosteroid, plasma exchange and intravenous immunglobuline respectively. CONCLUSION: The clinic was less recovery and stable for 6 year

Cranial Neuropathy in Multiple Sclerosis

OBJECTIVE: It has been reported that cranial neuropathy findings could be seen in the neurologic examination of multiple sclerosis (MS) patients, although brain magnetic resonance imaging (MRI) may not reveal any lesion responsible for the cranial nerve involvement. The aim of this study was to determine the frequency of brainstem and cranial nerve involvement, except for olfactory and optic nerves, during MS attacks, and to investigate the rate of an available explanation for the cranial neuropathy findings by lesion localization on brain MRI. METHODS: Ninety-five attacks of 86 MS patients were included in the study. The patients underwent a complete neurological examination, and cranial nerve palsies (CNP) were determined during MS attacks. RESULTS: CNP were found as follows: 3rd CNP in 7 (7.4%), 4th CNP in 1 (1.1%), 5th CNP in 6 (6.3%), 6th CNP in 12 (12.6%), 7th CNP in 5 (5.3%), 8th CNP in 4 (4.2%), and 9th and 10th CNP in 2 (2.1%) out of 95 attacks. Internuclear ophthalmoplegia (INO) was detected in 5 (5.4%), nystagmus in 37 (38.9%), vertigo in 9 (6.3%), and diplopia in 14 (14.7%) out of 95 attacks. Pons, mesencephalon and bulbus lesions were detected in 58.7%, 41.5% and 21.1% of the patients, respectively, on the brain MRI. Cranial nerve palsy findings could not be explained by the localization of the lesions on brainstem MRI in 5 attacks; 2 of them were 3rd CNP (1 with INO), 2 were 6th CNP and 1 was a combination of 6th, 7th and 8th CNP. CONCLUSION: The most frequently affected cranial nerve and brainstem region in MS patients is the 6th cranial nerve and pons, respectively. A few of the MS patients have normal brainstem MRI, although they have cranial neuropathy findings in the neurologic examination

Cranial Neuropathy in Multiple Sclerosis

OBJECTIVE: It has been reported that cranial neuropathy findings could be seen in the neurologic examination of multiple sclerosis (MS) patients, although brain magnetic resonance imaging (MRI) may not reveal any lesion responsible for the cranial nerve involvement. The aim of this study was to determine the frequency of brainstem and cranial nerve involvement, except for olfactory and optic nerves, during MS attacks, and to investigate the rate of an available explanation for the cranial neuropathy findings by lesion localization on brain MRI. METHODS: Ninety-five attacks of 86 MS patients were included in the study. The patients underwent a complete neurological examination, and cranial nerve palsies (CNP) were determined during MS attacks. RESULTS: CNP were found as follows: 3rd CNP in 7 (7.4%), 4th CNP in 1 (1.1%), 5th CNP in 6 (6.3%), 6th CNP in 12 (12.6%), 7th CNP in 5 (5.3%), 8th CNP in 4 (4.2%), and 9th and 10th CNP in 2 (2.1%) out of 95 attacks. Internuclear ophthalmoplegia (INO) was detected in 5 (5.4%), nystagmus in 37 (38.9%), vertigo in 9 (6.3%), and diplopia in 14 (14.7%) out of 95 attacks. Pons, mesencephalon and bulbus lesions were detected in 58.7%, 41.5% and 21.1% of the patients, respectively, on the brain MRI. Cranial nerve palsy findings could not be explained by the localization of the lesions on brainstem MRI in 5 attacks; 2 of them were 3rd CNP (1 with INO), 2 were 6th CNP and 1 was a combination of 6th, 7th and 8th CNP. CONCLUSION: The most frequently affected cranial nerve and brainstem region in MS patients is the 6th cranial nerve and pons, respectively. A few of the MS patients have normal brainstem MRI, although they have cranial neuropathy findings in the neurologic examinatio

Prevalence of and risk factors for cognitive impairment in patients with relapsing-remitting multiple sclerosis: Multi-center, controlled trial

Background: Cognitive impairment (CI) is a common problem in multiple sclerosis (MS), may occur either in early or late phase of the disease, and impairs quality of life. Objectives: This study aimed to determine the prevalence of CI and related risk factors in relapsing-remitting MS (RRMS) patients in Turkey