[Painful syndromes connected with disseminated sclerosis]

Multiple sclerosis (MS) is frequently regarded as a painless condition. A review of the literature reveals that approximately 2/3 of the patients with multiple sclerosis will experience painful syndromes during the course of disease and that these are associated with the disease. Acute syndromes are described: Trigeminal neuralgia, Lhermitte's sign, optic neuritis and tonic seizure. Chronic syndromes: Dysaesthesia, pain in extremities, muscular spasms, low back pain and headache. The frequency, causes and suggestions for treatment are mentioned. A Danish investigation has revealed that only 42% of a representative section of DS patients received adequate treatment for pain. It is thus concluded that optimal treatment of pain in MS patients is necessary.

Acute and chronic pain syndromes in multiple sclerosis

A representative sample of 117 patients with definite multiple sclerosis (MS) was interviewed on pain syndromes. Chronic syndromes lasting more than one month included dysaestesthesia, low back pain, spasms, tonic seizures, tightening and painful sensations in the extremities. Acute syndromes included neuralgia, L'Hermitte's sign and pain associated with optic neuritis. Thirty-five per cent were pain-free. Of the remaining patients had 45% pain at the time of the examination, 32% indicated pain among the most severe symptoms of MS and 23% had pain at the onset of MS. The number of patients with pain at the time of the examination increased with age and duration of disease. Patients with pain were significantly more often spastic and significantly more often sought alternative treatment forms. No difference was found for mean age, sex, physical impairment, duration of disease from onset of MS, depressive score and score of delayed verbal memory.

Multiple sclerosis: the impact of physical impairment and cognitive dysfunction on social and sparetime activities

In a cross-sectional investigation of 116 patients with multiple sclerosis, the social and sparetime activities of the patient were assessed by both patient and his/her family. The assessments were correlated to physical disability which showed that particularly those who were moderately disabled suffered from severe psychosocial strain. The literature shows that the strain becomes even more severe in certain periods of progression of the disease with the result that psychosomatic conditions arise.

Multiple sclerosis: symptom equivalent to delayed visual evoked potential latency

An investigation on the correlation between ability to read TV subtitles and the duration of visual evoked potential (VEP) latency in 14 patients with definite multiple sclerosis (MS), indicated that VEP latency in patients unable to read the TV subtitles was significantly delayed in comparison to that of patients who mastered this task.

[Traditional and alternative treatment of patients with multiple sclerosis]

The medicine consumption and the employment of alternative treatment were investigated in a material of 117 patients with disseminated sclerosis (DS) considered to be a representative sample of the patients with DS in the County of Funen. This investigation revealed that the preparations most commonly employed to modify the disease among patients with disseminated sclerosis were: spasmolytics, agents to counteract neurogenic bladder symptoms, benzodiazepine and analgesics. The consumption of medicine increased with increasing handicap. Employment of psychopharmaca was commonest in patients in social classes 4 and 5 and in women. In addition, is was found that there was no difference in social class, sex and age among the patients who employ alternative methods of treatment. The patients themselves have not experienced any effect from alternative treatment.

[Pregnancy and disseminated sclerosis. A retrospective study]

A retrospective investigation was undertaken on 64 female patients with disseminated sclerosis (DS) on the Island of Funen. The object was to investigate whether pregnancy and delivery influenced the course of the disease. The results were standardized for the age of commencement and the duration of the disease. In addition, the available literature on the subject is reviewed. It was found that the group of women in whom the disease commenced before or in connection with pregnancy or delivery had more severe physical handicaps than women without children or in whom the disease commenced after the last delivery. Women in whom the disease commenced in connection with the last delivery were most severely handicapped. In women in whom the disease commenced more than six months after the last delivery, the long term prognosis is not poorer than for women without children.

Multiple sclerosis: correlation of psychiatric admissions to onset of initial symptoms

Forty-two (12%) of a total of 366 patients with multiple sclerosis (MS) had psychiatric admissions. Of these, 34 (81%) had their first psychiatric admission in conjunction with or after the onset of MS. Classification by psychiatric diagnosis showed that there was a significant positive correlation between the onset of MS and the first psychiatric admission for psychoses and transient situational disorders, but not for neuroses.

Treatment of ventriculostomy-related infections

The results of the treatment of 15 cases of ventriculitis related to the use of external ventricular drainage are presented. A review of the literature on the treatment of cerebrospinal fluid shunt infections combined with our data suggest the following treatment of ventriculostomy-related ventriculitis: 1. Antibiotic treatment according to the resistance pattern of the infecting microorganism and 2. Removal or replacement of the ventricular drain. 3. One should wait for bacteriological cure before implanting a permanent internal drainage system.

Ventriculostomy-related infections--an epidemiological study

In a prospective study involving a total of 87 ventriculostomies, ventriculostomy-related infections (based upon a bacteriological definition) developed in 15 patients (17.2 per cent). Intraventricular haemorrhage was related to a higher infection rate. Infection was most frequent within the first days after the external ventricular drain (EVD) was inserted. There was no relation between infection and the number of manipulations of the EVD or antibiotic treatment during the time of EVD placement.