Bilateral Duane's syndrome associated with hypogonadotropic hypogonadism and anosmia (Kallmann's syndrome)

The neuro-ophthalmology of multiple sclerosis

Multiple sclerosis (MS) is a disease marked by focal demyelinating inflammatory plaques throughout the CNS. Neuro-ophthalmologic sequelae are common in MS and may arise from the disease itself or from treatment of the disease. Both afferent and efferent functions may be affected. Despite much progress, our understanding of the pathophysiology of MS, and the efficacy of our available treatments, remain inadequate. Here, we review the chief neuro-ophthalmologic abnormalities associated with MS and discuss the emerging diagnostic and therapeutic advances that are likely to further our understanding of MS and its treatment.

The Challenge of Axonal Path-Finding

Congenital syndromes of altered nervous system connectivity are reviewed along with recent findings on axonal growth: achiasma, congenital nystagmus, congenital horizontal gaze palsy, mirror movements and the syndromes of Kallmann, Wildervanck, Duane and Marcus Gunn. Identical guidance molecules are most likely involved in making axonal connections after injury and during development. Thus, investigations into variants of connectivity may help develop strategies to treat disconnections of axons in the adult.

Cranial Polyneuropathies in Multiple Sclerosis: Case Report and Literature Review

Although cranial neuropathies are common disorders in multiple sclerosis patients, multiple cranial nerve involvement is an unusual occurrence. Correlation of clinical symptoms with magnetic resonance imaging evidence of demyelinating central nervous system lesions can confirm the diagnosis. The authors report on the case of a 43-year-old woman who initially was thought to have suffered a brainstem infarct but, in fact, had developed multiple cranial nerve functional deficits. Treatment of multiple sclerosis remains primarily supportive in nature, with corticosteroids used for acute exacerbations and chronic progression.