Multiple sclerosis with recurrent meningitis.

Multiple sclerosis is an autoimmune demyelinating disease that is rarely associated with aseptic meningitis. However, certain syndromes causing aseptic meningitis are often associated with central nervous system demyelination that mimics multiple sclerosis (MS). Since many of these syndromes are potentially treatable, unmasking an alternative diagnosis is essential whenever an MS-like illness and recurrent meningitis are encountered in the same patient. Yet, the search for an alternative diagnosis may be elusive sometimes, despite extensive and appropriate investigations. We present a young woman with an MS-like illness associated with recurrent meningitis over a 7-year period. After an exhaustive evaluation, we conclude that recurrent meningitis is an atypical manifestation of MS. If neurologists would appreciate this point, unrewarding and costly investigations may be avoided and appropriate therapy instituted when similar cases are encountered in clinical practice.

Non paraneoplastic opsoclonus - myoclonus syndrome.

We analyzed the features of opsoclonus syndrome as a manifestation of post viral encephalopathy in 3 patients (one child and 2 adults). This is the first report of opsoclonus-myoclonus syndrome in the Arabian Peninsula. Symptoms appeared a few days after a viral-like illness in all patients. We excluded the possibility of paraneoplastic syndrome as investigations were carried out and follow-up did not reveal malignancy. One patient received a relatively long duration steroid treatment, another one received steroids in pulsed therapy, the third did not receive any specific treatment. The outcome was very good with improvement except in one who had severe sequelae.