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experience walking disturbance and 65% of patients with MS give the highest priority to mobility among factors affecting quality of life. Movement disorders could be a significant prognostic index of independence in patients with MS and one of the main indexes for monitoring disease progression and outcome of pharmacotherapy and rehabilitation. For this purpose, easy performed scales based on walking changes should be used. Materials and methods. The study included 51 patients with MS relapse, who filled a questionnaire of 20 questions about their age, gender, place of residence, family and social status, disease duration, course, treatment, and movement difficulties. The following walking-based measures were administered before and after MS relapse treatment: the Expanded Disability Status Scale (EDSS), the Multiple Sclerosis Walking Scale-12 (MSWS-12), and the 25-foot walk test (25FWT). Results. Before treatment of MS relapse with corticosteroids, EDSS score was 4.4±0.9, after - 3.5±0.9 (p<0.001); before treatment with corticosteroids and plasmapheresis EDSS score was 4.6±1.1, after - 3.8±1.2 (p<0.001); before treatment only with plasmapheresis EDSS score was 4.3±1.3, after - 3.7±1.4 (p<0.001). Before treatment of MS relapse with corticosteroids, MSWS-12 score was 37.05±8.9, after - 30.86±8.1 (p<0.001); before treatm ent with corticosteroids and plasm apheresis MSWS-12 score was 41.33±12.1, after - 35.95±11.7 (p<0.05). Before treatment of MS reiapse with corticosteroids, 25FWT score was 10.1 seconds (s)±4.3, after - 8.1s±3.3 (p<0.001); before treatment with corticosteroids and plasmapheresis 25FWT score was 10.8s±6.9, after - 9.8s±7.3 (p<0.001). Despite the type of treatment, there was a statistically significant moderate linear relationship between EDSS and MSWS-12 scores (r=0.611, p<0.05). The same correiation was found between MSWS-12 and 25FWT scores (r=0.597, p<0.05). Conclusions. There was a significant difference between results of EDSS, MSWS-12, 25FWT scales before and after MS relapse treatment with corticosteroids and plasmapheresis. Statistically significant improvement only of EDSS score was observed after MS retapse treatment with plasmapheresis. There was a moderate linear relationship between MSWS-12 and 25FWT scores. This confirms that there is a statistically significant correlation between MSWS-12 and 25FWT evaluations. [ABSTRACT FROM AUTHOR]

Tumor-like multiple sclerosis is one of the rare variants of multiple sclerosis. It presents with a large intracranial lesion, more than 2.0 cm in diameter, with mass effect, perilesional edema, and/or ring enhancement. Diagnostics is challenging and invasive methods are often used. A case of tumor-like multiple sclerosis is presented in this paper. The diagnosis was established without a biopsy. Relapsing-remitting course developed in less than six months. Also most recent studies regarding tumor-like multiple sclerosis are discussed, with special focus on diagnostics and treatment options. [ABSTRACT FROM AUTHOR]

We present a short history of multiple sclerosis. Four most prominent examples of the disease are reported in this article: virgin Lidwina, who lived in late Middle Ages, probably suffered from multiple sclerosis and later was announced saint; Augustus d'Este, grandson of King George III, whose diary shows the progression of neurologic disease and treatment failures; German poet Heinrich Heine, whose poetry inspired a number of composers, and despite the progressive disability, poet created till the death; English writer Margaret Gatty--her literary success was followed by the first signs of progressive neurologic disease. A short over view of the most important physicians and pathologists who worked in the field of multiple sclerosis is also introduced: Charles Prosper Ollivier d'Angers, who presented the first case report of multiple sclerosis in the scientific literature; Robert Carswell, the first illustrator of multiple sclerosis; Friedrich von Frerichs, who was the first who clinically identified, described disease and named it ''brain sclerosis'' (Hirnsklerose); Carl Rokitansky, the first who examined plaques under the microscope; Eduard Rindfleisch, who postulated that etiology of plaques probably are inflammatory factors carried in the blood stream to nervous system; Edmé Vulpian, who first used the term sclerose en plaque disseminée; Jean-Martin Charcot with his famous lectures in 1868 and clinical--an atomical observations of the disease; James Dawson, who studied morphology, inflammatory reactions, and tissue in filtration of the plaques. We also briefly introduce the first documented cases of probable multiple sclerosis written in the XVII century in Marian Miracle Books of the Great Duchy of Lithuania. [ABSTRACT FROM AUTHOR]

Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system. It is usually progressive and causes irreversible damage to the central nervous system leading to life long neurological disability. Are lapsing remitting form of the disease occurs initially in 85-90% patients. However, secondary progressive course of multiple sclerosis develops within 10-15 years in most cases. This article reviews the treatment of multiple sclerosis with monoclonal antibody natalizumab. Clinical trials provided a level evidence of natalizumab efficacy for treatment of relapsing remitting and secondary progressive multiple sclerosis. Natalizumab significantly reduces annual relapse rate and progression of disability as well as development of new demyelinating and contrast enhancing lesions of the central nervous system. Natalizumab, is well tolerated, serious side effects are rare. Patients on natalizumab treatment fall into higher risk category for progressive multifocal leuconcephalopathy, which is an opportunistic infectious disease of the central nervous system. The article provides recommendations and algorithms for stratifying the individual risk of progressive multifocal leucoencephalopathy and further patients' monitoring aiming to reduce the frequency and consequences of this complication. There is also a re view of patients treated with natalizumab in Lithuania, Vilnius University Hospitals Santariskiu klinikos Centre of Neurology. [ABSTRACT FROM AUTHOR]

Cognitive dysfunction is most common in neurodegenerative diseases which start at advanced age. Epilepsy and multiple sclerosis are diseases that can cause cognitive dysfunction for young persons, which is un common for healthy individuals and isn't associated with neither physiological changes of advanced age nor with neuronal death. The aim of this study was to investigate cognitive features of persons with multiple sclerosis, and epilepsy and healthy controls, locate cognitive impairments and assess their relationships with disease, health and demographic variables. 90 persons participated in this study: 30 with epilepsy, 30 with multiple sclerosis and 30 healthy controls. Individuals with multiple sclerosis or epilepsy were taken from VUL SK Neurology Department and VULS SK Consultation Clinic. Cognitive functions were assessed with CANTABeclipse 3.0.0 neuropsychologic test battery. The selected tests assess 1. choice reaction time; 2. working memory capacity; 3. spatial planning and spatial working memory; 4. episodic learning and memory. The results showed impaired cognitive functioning in epilepsy and multiple sclerosis groups compared to control group. Persons with multiple sclerosis performed significantly worse on tests of choice reaction time, spatial span and spatial planning; persons with epilepsy -- on tests of spatial span, spatial planning and episodic learning and memory. Cognitive dysfunction in persons with epilepsy correlates with disease duration and seizure frequency. In persons with multiple sclerosis, physical disability and disease duration were not associated with cognitive abilities. In all three groups age, but not education, had significant influence on performance on tests of episodic learning and memory. Correlations between sex and cognitive abilities were found: control group men showed shorter reaction times, epilepsy group men per formed better on spatial working memory tasks, multiple sclerosis group women made less mistakes in choice re action time test. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) is used by one- half to three-fourths of patients with multiple sclerosis (MS). CAM therapies have different effects on MS. Some of them such as cranberries, vitamin D, physical activity, and diet are possibly beneficial. Other therapies such as cerebral vein angioplasty and/or stenting, hyperbaric oxygen, and immune--stimulating supplements are inefective, harmful and should not be used. Neurologists and health care professionals should provide evidence--based information about CAM therapies to patients with MS. Five MS patient cases from Vilnius University Hospital Santariskiu Klinikos, Department of Neurology iliustrate unfortunately wrong patients' decision on choosing CAM. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is an inflammatory demyelinating disorder of central nervous system that is the major course of the disability of young adults. Cogiivim pairment can occur even in early stages of MS and also in clinically isolated syndrome (CIS). As disease modifying drugs (DMD) can at ten u ate inflammatory processes and prevent brain atrophy, they may also have positive benefits oncognitivedys function in MS patients. Clinical trials demonstrate that interferon beta and natalizumab positively affect cognitive functions in MS patients. Most patients with relapsing multiple sclerosis had stable cognitive performance during 10 years of pro spective evaluation, some of which may be related to the therapeutic effect of glatirameracetate. There is clear evidence that early DMD treatment has positive effect on cognitive functions, until clinically isolated syndrome has not converted to definite MS. Immunosupressants (mitoxantrone and cyclophosphamide) can also positively affect cognitive functions in MS. Further studies are needed for de tailed evaluation of DMD effect on cognitive dysfunction in MS. [ABSTRACT FROM AUTHOR]