[Vertebral syndrome in multiple sclerosis: causes, clinical peculiarities and problems of differential diagnosis]

Presented is a review of the literature on the main causes of vertebral syndrome in multiple sclerosis (MS): dystrophic processes in spinal motor segments, disturbance of spinal static, development of functional blockade, osteoporosis, appearance of demyelinization foci in roots and the spinal cord, myelopathy, replacing foci by cavities. The authors report the results of clinical and MRI study of 115 patients with MS and single out some dissimilarities of vertebral syndrome in MS and dystrophic lesion of spinal cord as follows: in MS pain is long-term, non-intensive, without distinct periods of deterioration and improvement; muscle tonic disturbances are less pronounced but present on the level of all spinal compartments; intensity of root disorders is significantly less and location of clinical symptoms often does not correspond to the level of altered spinal motor segments. The Lermitt symptom and its analogs are described, the former being found in 14.7% of patients with remitting course, and their relation to the loci in the cervical part of the spinal cord is revealed. It is stressed that these loci could lead to an earlier onset of vertebral pain syndrome in patients with MS.