Autonomic dysfunction occurs frequently in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Patients with either condition may present with autonomic symptoms such as bladder, sexual, cardiovascular, thermoregulatory, and gastrointestinal dysfunction, and fatigue, but autonomic symptoms that affect quality of life are underrecognized in clinical practice. The immunopathogenesis of MS has been considered to be associated with autonomic dysfunction. Applying appropriate treatment strategies for autonomic dysfunction is important to improve the quality of life of patients. Here we review autonomic dysfunction and how this is managed in patients with MS and NMOSD.

Citations

• Sexual function and related predictors in male with multiple sclerosis and neuromyelitis optica spectrum disorder: a case–control study
  Saeed Vaheb, Mohammad Yazdan Panah, Mohammad Mohammadi, Mohammad Amin Sadri, Narges Ebrahimi, Sarina Loghmani, Marjan Beigi, Vahid Shaygannejad, Omid Mirmosayyeb
  The Journal of Sexual Medicine.2025; 22(2): 274.     CrossRef

An infection is less likely to elicit chronic inflammatory demyelinating polyneuropathy (CIDP) than Guillain-Barré syndrome. We here report a case of acute-onset CIDP following hepatitis A virus infection and briefly comment on the potential mechanisms regarding the induction and chronicity of autoimmunity after a viral infection.

Citations

• Varicella‐zoster virus‐related neurological complications: From infection to immunomodulatory therapies
  Mohammed Ageeli Hakami, Farhan R. Khan, Osama Abdulaziz, Khalid Alshaghdali, Ali Hazazi, Awad F. Aleissi, Adil Abalkhail, Bader S. Alotaibi, Abdulfattah Yahya M. Alhazmi, Neelima Kukreti, Abdulkarim S. Binshaya
  Reviews in Medical Virology.2024;[Epub]     CrossRef
• A rare kind of Guillain-Barre syndrome triggered by acute hepatitis A infection in a pediatric patient: a case report and review of literature
  Erfan Shahabinejad, Amirreza Shakoeizadeh, Alireza Vakilian, Seyyed Mohammad Alipour, Fatemeh Jalali, Faezeh Ebrahimi, Narges Mashyekhi
  Journal of NeuroVirology.2024; 30(5-6): 559.     CrossRef
• Hyperacute relapse of Lewis-Sumner syndrome during influenza A (H1N1) virus infection
  Luís Ribeiro, Ana Monteiro, João Martins
  BMC Neurology.2020;[Epub]     CrossRef

Acute disseminated encephalomyelitis (ADEM) and acute hemorrhagic leukoencephalitis (Hurst

Eosinophilic fasciitis (EF), also known as Shulman syndrome, is an inflammatory disorder of unknown etiology. It usually presents with pain, swelling, and tenderness of the proximal aspect of the limbs, chest, or neck, with subsequent induration of the skin and subcutaneous tissues, in association with peripheral eosinophilia. EF is differentiated from scleroderma by the pattern of skin involvement and non-involvement of muscle. We report a case of progressive EF presented with tightness and stiffness in all limbs.

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Background
Myasthenia gravis (MG) and systemic lupus erythematosus (SLE) are well recognized to coexist and have some similarities in immunologic, clinical and serologic findings. Despite several reports of the association with autoantibodies and thymectomy in these disorders, the pathomechanism of coexistence remains to be elucidated.Objective: We aimed to investigate the relationship of MG and SLE through overall features of patients with both disorders;: clinical, laboratory, and electrophysiological findings.Materials and Methods: We reviewed the medical records of 6 consecutive patients with MG and SLE (2 men, 4 women, ages 17-51, mean 30.5 years, Seoul National University Hospital, from 1998 to 2005).Results: Three patients who developed SLE first, had ocular type of MG and 2 were children showing much severe and recurrent SLE features and only 1 patient had thymic hyperplasia. The other 3 developed MG first and they were generalized type and none underwent thymectomy. In addition, the development of MG or SLE was not coincident with remission or improvement of another disorder.Conclusion: The coexistence of SLE and MG may support the hypothesis of two different antibody populations modulated by thymus in the opposite extremesThis report suggests that the systemic and extensive autoimmune response in preceding MG or SLE may effect the development of the other disorder followed, while. the coexistence of two disorders cannot be explained by the hypothesis of two different antibody populations modulated by thymus in the opposite extremes The role of thymectomy and the theorectical subsequent effect on the development of SLE have been debated with controversy. However, SLE occurred without thymectomy in MG and these disorders did not develop in the quiescent period of another disorder. Therefore, the other pathomechanism for the coexistence of MG and SLE should be elucidated.

Background
The most distal sensory fibers of the feet are often affected first in polyneuropathy. However, they are not evaluated in routine nerve conduction studies. Thus we evaluated the dorsal sural sensory nerve in patients with sensorimotor polyneuropathy with normal sural response, in order to assess the usefulness in electrodiagnostic practice.Methods: In this study, 53 healthy subjects and 27 patients with clinical evidence of sensorimotor polyneuropathy were included. In all subjects, peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. On electrodiagnostic testing, all patients had normal sural responses.Results: The dorsal sural sensory nerve action potentials (SNAPs) mean amplitude was 13.12

Background
There is no currently effective treatment for amyotrophic lateral sclerosis (ALS), although this disorder is a progressive neurodegenerative disease resulting in death within several years. Because recent evidence suggests that homocysteine (HC) is highly related to neurodegenerative disorders with aging, we tried to elucidate the effects of multi-vitamin therapy on G93A SOD1 transgenic mice.Methods: We treated this murine model of ALS with multi-vitamin (folic acid 1.97 mg/day, pyridoxine 0.98 mg/day, cyanocobalamin 0.1 mg/day) from 45 days of age, per oral. We performed the rotarod test from postnatal 10th week,weekly.Results: We found that multi-vitamin reinforcement significantly prolonged average lifespan and delayed disease onset with improvement of motor performance. However, it did not significantly slow disease progression and statistical differences of weight loss were not observed between in transgenic mice and controls.Conclusions: These results suggest that multi-vitamin can be a potent therapeutic strategy for familial forms of ALS.

Marcus Gunn jaw winking phenomenon has been thought to result from a congenitally abnormal innervation of the levator palpaebrae muscle by a branch of the trigeminal nerve. A 22-year old man presented with bilateral eyelid elevation on the chewing or eating since infancy. Neurological examination showed bilateral Marcus Gunn Jaw wingking phenomenon in this patient. We referred this patient to the department of ophthalmology and plastic surgery for levator resection or orbicularis oculi muscle flap. We report bilateral Marcus Gunn jaw winking phenomenon, although unilateral disorder is the most common form of trigemino-oculomotor synkinesis. Neurologists should be aware of this phenomenon for decision of proper management and take detailed neurologic examination for elucidating the association of other cranial nerves.

We report a 31-year-old man with cerebral adrenomyeloneuronopathy variant, who presented as progressive gait disturbance. He had spastic paraparesis, hyperreflexia without Babinski