[Involvement of the audiovestibular system in multiple sclerosis]

Multiple sclerosis [MS] is a chronic demylinated disease of central nervous system which strikingly has racial and geographic differences in prevalence and symptoms. Audiovestibular involvement is relatively common in MS. In a descriptive prospective cross-sectional study on 36 patients who fulfill McDonald criteria of MS history of Audiovestibular symptoms was recorded and audiologic assessment including tunning fork, speech and pure tone audiometry, tympanometry and auditory brainstem response [ABR] performed. The mean age was 29 year [range: 18-48] and female to male ratio was 17. The most common symptoms in otoneurologic domain were balance disorders [63.5%] and in 16.7% cases there was true vertigo. In audiometry 22.2% sensoryneural hearing loss mainly unilateral was repotted. ABR in 44.4% had abnormality in morphology or latency. Vertigo in 5.6% and hearing loss in 2.8% were the first symptoms. Audiovestibular involvement is fairly common and occasionally it can be the first symptom in MS, so an otorhinolaryngologist has better consider this diagnosis when a patient refers with this symptom especially in young women

[Frequency and clinical characteristics of amyotrophic lateral sclerosis [ALS] disease in patients referred to neurology department of ghaem hospital]

ALS is a neurodegenerative disease due to degeneration of both upper and lower motor neurons [UMN and LMN]. There is no treatment for this disorder and it is important to distinguish from other conditions that may mimic ALS. This is a descriptive study since September 2002 until September 2004 among the patients whom referred to neurology department of Ghaem hospital. 21 patients were studied [14 men]. Mean age was 41.58 years. UMN and LMN symptoms were the presenting complaint of our patients except 5 cases with bulbar onset. Symptoms began before age of 40 in 40% of our all patients, and 27% of Charcot type of ALS. 15 Cases had charcot type of ALS, 4 cases had juvenile ALS, 1 case had Kennedy syndrome and finally 1 case had Madras motor neuron disease [MMND]. In this study we found the first case of MMND in Iran. There was a large proportion [40%] of cases with age of onset below 40 years in comparison with previous studies, more epidemiological and toxicological studies should be done