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Involuntary ocular deviations and generalized dystonia in multiple sclerosis. A case report
J J Barton1, T A Cox, D A Calne
1Division of Neurology, University of British Columbia, Vancouver, Canada.
Summary
Urinary tract infections can trigger relapses in multiple sclerosis patients, causing involuntary movements like blepharospasm and chorea. Lesions near the caudate and lentiform nuclei were observed in one such case.
Area of Science:
- Neurology
- Neuroimmunology
- Infectious Disease
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Relapsing-remitting MS is characterized by periods of new symptoms or relapses.
- Urinary tract infections (UTIs) are common in MS patients and can precipitate relapses.
Observation:
- A patient with chronic relapsing multiple sclerosis experienced neurological symptoms during UTIs.
- Symptoms included involuntary ocular deviations, blepharospasm, torticollis, and chorea affecting the right arm and head.
- Magnetic Resonance (MR) imaging revealed lesions adjacent to the right caudate and lentiform nuclei.
Findings:
- The study highlights a correlation between UTIs and exacerbation of neurological symptoms in MS.
- Specific movement disorders were observed during infectious relapses.
- Lesion localization near basal ganglia structures (caudate and lentiform nuclei) was noted.
Implications:
- Understanding infection triggers is crucial for managing MS relapses.
- The findings suggest a potential link between basal ganglia involvement and infection-induced exacerbations in MS.
- Further research may explore targeted interventions to prevent infection-precipitated relapses in multiple sclerosis.