Real time optic nerve sheath diameter measurement during lumbar puncture.

Measurement of optic nerve sheath diameter (ONSD) using point of care ultrasound has been used to indirectly assess the intracranial pressure (ICP) particularly in conditions where it is raised. Direct pressure measurements using probes reaching the ventricle system correlated with ONSD using ultrasound. Attempts were made to measure the ONSD pre and post lumbar puncture (LP) after draining cerebrospinal fluid (CSF) as well as post ventricular shunt placement.

Multiple sclerosis and Epstein-Barr virus: a growing association.

The etiology of multiple sclerosis is an elusive field due to the lack of the usual cause-effect relationship model to explain a disease. In fact, with all the current evidence we start thinking in multiple sclerosis as a multi-factorial disease, where an infective agent on a genetically permissive host can lead to inflammation, demyelination and ultimately to neurological damage with dire consequences for the patients. This review will focus on the role of viruses in multiple sclerosis etiology and give some insight regarding this complicated issue.