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Related Experiment Videos

Normal conduction in pathways traversing an asymptomatic multiple sclerosis plaque.

M A Ross¹, A A Leis, L Krain

¹Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City 52242.

Electroencephalography and Clinical Neurophysiology

|February 1, 1992

Summary

Facial myokymia in multiple sclerosis (MS) can present atypically. This case highlights how electrophysiological tests may better reflect MS lesion impact than MRI findings.

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Area of Science:

Neuroscience
Neurology
Clinical Neurophysiology

Background:

Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system.
Facial myokymia is an uncommon initial symptom of MS.
Brainstem lesions in MS can cause diverse neurological deficits.

Observation:

A 31-year-old woman presented with right facial myokymia as the first sign of MS.
MRI revealed a focal lesion in the left dorsolateral pontomedullary region.
Standard evoked potential tests (BAEPs, SEPs, BR) showed no conduction block at the MRI-identified lesion.

Findings:

Electrophysiological abnormalities (BAEP, BR) indicated a conduction defect in the right pons, correlating with facial myokymia.
Electromyography (EMG) confirmed myokymic discharges in the right facial muscles.

Related Experiment Videos

The study documents normal conduction across a presumed asymptomatic MS plaque, suggesting the MRI signal may represent edema rather than demyelination.

Implications:

This case challenges the direct correlation between MRI signal abnormalities and clinical/electrophysiological deficits in MS.
It underscores the importance of integrating clinical, electrophysiological, and imaging data for accurate MS diagnosis and assessment.
Findings suggest that MRI signal changes in MS plaques might not always signify active demyelination or functional impairment.