Multiple sclerosis in the otoneurology outpatient clinic: interdisciplinary cooperation between otoneurologist and neurologist

Summary Introduction: Multiple sclerosis (MS) is a chronic multifocal inflammatory disease affecting the CNS, with autoimmune and neurodegenerative processes involved in its pathogenesis. Otoneurology outpatient clinic patients presenting with hearing loss, tinnitus, and vertigo may eventually be newly dia­gnosed MS patients. An otoneurologist specialist may be the first physician to suspect MS and refer the patient for an MRI and neurological examination. Early dia­gnosis and subsequent treatment of MS can delay permanent disability. Aim: Analysis of the incidence of MS patients in an otoneurological outpatient clinic during a twenty-year period. To increase the otoneurologists’ awareness of MS dia­gnosis. Methods and materials: Of 6,000 patients, who were newly examined in an otoneurology outpatient clinic between 2000 and 2021, data of 11 patients (0,18%) (5 male/6 female, aged 25–58 years) with MS or suspected of MS were retrospectively evaluated. Results: In 11 patients, MS was suspected or ongoing. In 4 of those patients, otoneurological examination contributed to the first detection of MS by an otoneurologist. The first MS symptoms included hearing loss, tinnitus, instability, and post-infection visual disorder. Conclusion: The otoneurologist must consider that sudden hearing loss, tinnitus, and vertigo may be the first manifestations of MS. Early dia­gnosis of MS increases the likelihood that with treatment, the progression of the disease will be slowed. Interdisciplinary cooperation between the otoneurologists and neurologists is very important for the dia­gnosis of MS. Key words multiple sclerosis – sensorineural hearing loss – tinnitus – vertigo – otoneurology

Clinic of ophthalmic lesions of the eye in multiple sclerosis

A literature review on the problem of multiple sclerosis (MS) with an emphasis on its ophthalmic manifestations is presented. This eye disorders are one of the most frequent early symptoms, along with unexplained weakness, absent-mindedness, memory impairment and other neurological complaints. The most common symptom of lesion is oculomotor disorders. Special attention is paid to such typical ophthalmic pathology of multiple sclerosis as optic (retrobulbar) neuritis. A number of features of the course of optic neuritis in multiple sclerosis are described, which help to establish the correct diagnosis. Key words: multiple sclerosis, ocular manifestations, optic (retrobulbar) neuritis.

Ophthalmological aspects of multiple sclerosis

The article presents a literature review on the issue of multiple sclerosis (MS) and its ophthalmological manifestations: etiopathogenesis, possible causes of development, peculiarities of the clinical picture, including the eyes, modern diagnostic capabilities and treatment approaches. Special attention is paid to such a typical for MS ophthalmopathology as optical (retrobulbar) neuritis. The authors present their own practical cases. Key words: multiple sclerosis, diagnosis, treatment, ocular manifestations, optical (retrobulbar) neuritis.

Prevalence of Complex Regional Pain Syndrome in a Cohort of Multiple Sclerosis Patients

Background: More than 50% of multiple sclerosis patients experience chronic pain syndrome. We set out to determine the specific type of chronic pain that was seen in our multiple sclerosis patients. Methods: Patients with multiple sclerosis were catalogued between January 2002 and April 2006 and identified by a search of the database. Only MS patients that met the 2005 revised McDonald criteria were included. Results: We determined the prevalence rate of complex regional pain syndrome in a cohort of multiple sclerosis patients. In our sample of 205 multiple sclerosis patients, the prevalence of complex regional pain syndrome was 4 cases per 205 compared to an expected age and sex-adjusted total prevalence of 0.078 cases per 205 (p < 0.0001). Conclusion: This study suggests that multiple sclerosis patients are at a higher risk of developing complex regional pain syndrome than the general population. Key words: Multiple sclerosis, complex regional pain syndrome, prevalence