Contributions
Abstract: EP1464
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - Neurophysiology
Background and objectives: To integrate neurophysiological findings with clinical and imaging data in a consecutive series of multiple sclerosis (MS) patients developing facial numbness during the course of an MS attack.
Methods: Eight consecutive patients with MS and recent-onset facial numbness were studied clinically, imaged with routine MRI, and assessed neurophysiologically with trigeminal somatosensory evoked potential (TSEP), blink reflex (BR), masseter reflex (MR), facial nerve conduction, facial muscle and masseter EMG studies.
Results: All patients had ipsilateral facial hypoesthesia on examination, lesions in the ipsilateral pontine tegmentum on MRI, and abnormal TSEPs upon stimulation of the affected side. BR was the second most sensitive neurophysiological method with 5/8 examinations exhibiting an abnormal R1 component, allowing localization of the responsible pontine lesion, which closely corresponded with MRI findings. The MR was abnormal in 3/5 patients, always on the affected side. Facial conduction and EMG studies were normal in all patients but one.
Conclusions: Neurophysiological assessment of MS patients with facial numbness is a sensitive tool, which can improve lesion localization and, combined with clinical and imaging findings, can allow integration of symptoms, signs, anatomy and physiology.
Disclosure:
G. Koutsis has received research grants from Genesis Pharma and Teva, consultation fees, advisory boards and honoraria from Genzyme, Genesis Pharma, Teva and Novartis.
M.E. Evangelopoulos has provided consultation services for and received honoraria from Novartis, Biogen and Teva.
P. Kokotis reports no conflict of interest.
A. E. Papagianni reports no conflict of interest.
N. Karandreas reports no conflict of interest.
Abstract: EP1464
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - Neurophysiology
Background and objectives: To integrate neurophysiological findings with clinical and imaging data in a consecutive series of multiple sclerosis (MS) patients developing facial numbness during the course of an MS attack.
Methods: Eight consecutive patients with MS and recent-onset facial numbness were studied clinically, imaged with routine MRI, and assessed neurophysiologically with trigeminal somatosensory evoked potential (TSEP), blink reflex (BR), masseter reflex (MR), facial nerve conduction, facial muscle and masseter EMG studies.
Results: All patients had ipsilateral facial hypoesthesia on examination, lesions in the ipsilateral pontine tegmentum on MRI, and abnormal TSEPs upon stimulation of the affected side. BR was the second most sensitive neurophysiological method with 5/8 examinations exhibiting an abnormal R1 component, allowing localization of the responsible pontine lesion, which closely corresponded with MRI findings. The MR was abnormal in 3/5 patients, always on the affected side. Facial conduction and EMG studies were normal in all patients but one.
Conclusions: Neurophysiological assessment of MS patients with facial numbness is a sensitive tool, which can improve lesion localization and, combined with clinical and imaging findings, can allow integration of symptoms, signs, anatomy and physiology.
Disclosure:
G. Koutsis has received research grants from Genesis Pharma and Teva, consultation fees, advisory boards and honoraria from Genzyme, Genesis Pharma, Teva and Novartis.
M.E. Evangelopoulos has provided consultation services for and received honoraria from Novartis, Biogen and Teva.
P. Kokotis reports no conflict of interest.
A. E. Papagianni reports no conflict of interest.
N. Karandreas reports no conflict of interest.