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Unlabelled: Abnormalities in the ocular-motor reflex recorded in electronystagmography may indicate central vestibular system impairment. Multiple sclerosis (MS) is the most common chronic, debilitating disease characterized by focal demyelinization that develops throughout the central nerves system at varying time. The aim of the study was to apply the quantitative analysis of ocular-motor tests to evaluation degree of the central system impairment in MS patients., Material and Methods: The study was carried on 60 MS patients consulted in Balance Division, Otolaryngology Clinic, Medical University of Lodz, from 2002 to 2004, and 50 healthy persons as the control group. Clinical otoneurolaryngological examinations and electronystagmography tests (smooth pursuit, optokinetic, saccades) were performed in all patients. We apply the quantitative Z score analysis for gain in smooth pursuit test, slow phase velocity in optokinetic, maximal velocity of the saccades. Depending on Z score value the patients were qualified into one of three scale dysfunctions., Results: Statistical correlation were found between results of all ocular-motor tests outcome in MS patients and control group. In smooth pursuit test most often second degree (35.0%), in OKN test first degree (28.3%) and in saccades the third degree (31.6%) of dysfunction was observed. The higher the values of Z score, the more abnormal results of ocular-motor reflex were observed., Conclusion: Application of the quantitative Z score analysis of the ocular-motor tests results demonstrating the degree of central ocular-motor system dysfunction in MS patients. This method may assist in monitoring the central vestibular system impairment and in evaluation course of the disease and degree of neurological disability.

Unlabelled: Otoneurologic bedside examination with testing eye movements gives valuable information about static and dynamic properties of balance system and may give topodiagnostyc information about the side of lesion in patients with vertigo, dizziness and disequilibrium., The Aim of the Study: was to present the scheme of otoneurological bedside examination and usefulness of ocular motor disturbances index in evaluation of Multiple Sclerosis patients status., Material and Methods: Sixty patients with diagnosis of MS, seen in outpatient neurology clinic, Medical University of Lodz, from 2002 to 2004, were enrolled into the study. Patient's history of vertigo, dizziness, hearing loss and vision disturbances were evaluated. The clinical bedside ocularmotor examination was performed in all patients. It was composed of seven tests on the basis on which we introduce ocular motor disturbances index--IRZ., Results: The most frequent abnormalities were found in clinical saccadic test in 30% and smooth pursuit in 22%. MS patients who had in clinical eye movements examination IRZ bigger than 3 point formed the abnormal clinical examination group' (ACE)-- 31.7%. In u 68.3% the index was less than normal clinical examination group' (NCE). The longer duration of the disease was observed in ACE group. Comparisons of functional neurological score EDSS and for cerebellar and brainstem subscale were significantly greater in ACE group., Conclusion: Otoneurological bedside examinations with dynamic tests and introducing quantitative the ocular motor disturbances index is a valuable method of evaluation of visual-ocularmotor reflex and may be used in monitoring MS course of disease.