Pathophysiological background and clinical characteristics of sleep disorders in multiple sclerosis.

Sleep disorders in multiple sclerosis (MS) are more common than in general population and are considered to be one of the important etiological factors in development of fatigue, most common and debilitating symptom of MS. Although almost all of the major subgroups of sleep disorders such as insomnia, sleep disordered breathing, REM sleep behavior disorder, narcolepsy and restless legs syndrome have been described in the MS patients their higher prevalence in MS population than in healthy controls in some of the sleep disorders is not fully elucidated. Immunological background in disease development in both multiple sclerosis and sleep disorders have been proposed as possible common pathophysiological mechanism and recent findings of disrupted melatonin pathways in MS patients suggest multi-level causative mechanism of the development of sleep disorders in MS.

Autonomic dysfunction in multiple sclerosis.

Multiple sclerosis (MS) is the leading cause of neurological disability in young adults. Since the pathophysiology of MS is characterized by dissemination in space, as well as in time, the autonomic nervous system is inevitably damaged in the course of the disease in many patients and the proportion of affected patients increases with disease duration. Autonomic dysfunction (AD) in MS is explained by lesions in regions responsible for autonomic regulation such as nuclei in the periventricular region of fourth ventricle in the brainstem as well as medullar lesions.

Diagnostic approach of patients with longitudinally extensive transverse myelitis.

The aim of this study is to present a diagnostic and therapeutic approach in patients with LETM. In a period between June 2008 and June 2010, all patients who fulfilled criteria for LETM were included in the study. All patients underwent a standardized protocol of investigations presented in this paper.

Rare infections mimicking MS.

The diagnosis of multiple sclerosis (MS), despite well defined clinical criteria is not always simple. On many occasions it is difficult to differentiate MS from various non-MS idiopathic demyelinating disorders, specific and infectious inflammatory diseases or non-inflammatory demyelinating diseases. Clinicians should be aware of various clinical and MRI "red flags" that may point to the other diagnosis and demand further diagnostic evaluation.