Purpose Of Review: In multiple sclerosis (MS), symptoms vary widely from patient to patient. Certain events in MS are well recognized (eg, optic neuritis, brainstem and spinal cord relapses) and do not lead to much clinical confusion. However, other events that occur in MS may be less expected and may be underrecognized by some clinicians and may lead to an extensive and potentially unnecessary investigation for what is a known problem in MS.
Recent Findings: This article reviews Lhermitte sign, Pulfrich phenomenon, Uhthoff phenomenon, and the useless hand of Oppenheim, along with the underrecognized phenomena of transient neurologic events (including tonic spasms). Disorders of temperature regulation in MS (likely based on hypothalamic involvement) which can present with bizarre behavioral change and evade diagnosis, are also discussed. The article concludes with a review of epilepsy and sleep disorders in MS, both of which appear to occur at an increased frequency in the MS population and may have implications for therapy.
Summary: This article is meant to help clinicians recognize and treat this fascinating set of underrecognized phenomena in MS and perhaps save patients trips to the emergency department, extraneous testing, and ineffective intervention.
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http://dx.doi.org/10.1212/01.CON.0000433287.30715.07 | DOI Listing |
BMC Neurol
January 2025
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Introduction: As the most frequent chronic neurological disorder in young adults, Multiple sclerosis (MS) significantly affects neurological function, particularly the autonomic nervous system. While the physical symptoms are visible, MS also causes hidden effects like sexual dysfunction. Research indicates that sexual disorders are more prevalent in MS patients compared to other neurological conditions and are approximately five times more common than in the general population.
View Article and Find Full Text PDFNat Commun
January 2025
Neurochemistry Laboratory, Department of Laboratory Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.
DOPA Decarboxylase (DDC) has been proposed as a cerebrospinal fluid (CSF) biomarker with increased concentrations in Lewy body disorders (LBDs) and highest levels in patients receiving dopaminergic treatment. Here we evaluate plasma DDC, measured by proximity extension assay, and the effect of dopaminergic treatment in three independent LBD (with a focus on dementia with Lewy bodies (DLB) and Parkinson's disease (PD)) cohorts: an autopsy-confirmed cohort (n = 71), a large multicenter, cross-dementia cohort (n = 1498) and a longitudinal cohort with detailed treatment information (n = 66, median follow-up time[IQR] = 4[4, 4] years). Plasma DDC was not altered between different LBDs and other disease groups or controls in absence of treatment.
View Article and Find Full Text PDFNeurotherapeutics
January 2025
Department of Human Neurosciences, Sapienza University, Rome, Italy. Electronic address:
Ocrelizumab (OCR) and Natalizumab (NTZ) are highly effective treatments widely used in Multiple Sclerosis (MS). However, long-term, real-world comparative data on clinical effectiveness, safety and treatment persistence are limited. This retrospective analysis included relapsing and progressive MS patients initiating treatment at two Italian Universities ("La Sapienza" and "Federico II").
View Article and Find Full Text PDFValue Health
January 2025
Department of Cardiology and State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Objective: Our objective was to develop and assess the psychometric properties of relevant bolt-on items for the EQ-5D-5L in patients with rare diseases (RDs).
Methods: Nineteen new EQ-5D-5L bolt-ons were developed based on literature review, expert input and qualitative interviews and focus groups with patients, caregivers and representatives of patient associations. A nationwide, cross-sectional, web-based survey in China included patients or caregivers of patients with 31 RDs in China (n=9,190).
Mult Scler Relat Disord
January 2025
University of Health Sciences, Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Neurological Disorders, Department of Neurology, Istanbul, Türkiye. Electronic address:
Background: Multiple sclerosis (MS) patients frequently experience gait disturbances, which can be exacerbated in those with vestibular involvement. Various exercise approaches are available to address gait difficulties in this patient population, and the use of vestibular rehabilitation, in particular, has increased recently. However, the effects of this specific exercise approach on gait in MS patients remain unclear.
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