Acta Neurologica Scandinavica 104
(6), 380-384
Daniel E. Jacome
Department of Medicine, Franklin
Medical Center, Greenfield, Massachusetts 01301 and Section of Neurology,
Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire 03756
Objective
Keane described 2 patients with gaze-evoked
blepharoclonus (BLC), a form of reflex BLC, and multiple sclerosis (MS).
A search for common areas of demyelination and focal axonal atrophy (T1
black holes) of the central nervous system (CNS) in 11 patients with MS
exhibiting eyelid closure BLC was conducted employing magnetic resonance
imaging (MRI). Finding lesions in common CNS locations on these patients
can help to elucidate the pathogenesis of this restricted movement disorder.
Materials and
Methods
Eleven adult patients with relapsing–remitting,
primary or secondary progressive MS were studied. MRI views were completed
employing a 1.5-tesla scanner. Contrast Axial T1 imaging was obtained in
9 patients.
Results
T1 black holes were not identified.
Ten patients had multiple, scattered periventricular (PV) areas of demyelination.
Four patients exhibited brainstem lesions of diverse but inconsistent locations
including midbrain, cerebellar peduncle, pons and medulla. In 2 of the
patients the brainstem lesions were transient but BLC persisted after the
lesions regressed.
Conclusion
No common areas of CNS demyelination
or focal axonal atrophy were identified on these patients with MS and BLC.
The pathogenesis and clinical significance of BLC in MS remains to be elucidated.
© Munksgaard 2001