Background: Natalizumab is a humanized monoclonal antibody with high efficacy and an acceptable safety profile used in the treatment of patients with multiple sclerosis (MS). Objectives: Our aim was to report data regarding long-term administration of Natalizumab in patients with relapsing-remitting multiple sclerosis (RRMS) from our clinic. Methods: A retrospective observational study was performed including RRMS patients who underwent treatment with ≥ 24 Natalizumab infusions. We analyzed the EDSS values, the relapse rate and the rate and type of adverse events related to Natalizumab administration. Results: 51 subjects were included with a predominance of women (62.74%), an average age of 40.43±1.49 years, a mean disease duration of 9.86±0.7 years and mean number of Natalizumab infusions of 45.58±2.74. An increased number of patients (80.39%) were relapse-free and there was observed a mild reduction of the mean EDSS value following Natalizumab initiation in patients who had not been treated with other disease modifying therapies anteriorly. Among the encountered adverse events we registered: increased liver transaminases (13.72%), local infections (7.84%) and dysmenorrhea in one patient. The rate of severe adverse events was 3.92 and there were registered no cases of Progressive Multifocal Leukoencephalopathy (PML). Conclusions: Natalizumab proves to be effective, has an adequate safety profile and can be administered with good tolerability for a rather extended period of time, provided that the patients are closely monitored.

Mesial temporal sclerosis (MTS) is a pathology usually seen in young individuals. It is responsible for partial seizures, with possible secondary generalization. It may be initially managed with antiepileptic agents, but eventually some patients may be refractory to medical treatment. Authors report the case of a 21 year old man with generalized tonic–clonic seizure and a suggestive cerebral MRI for bilateral hippocampal sclerosis. MTS remains a controversial pathology, which requires a long term management, with an unpredictable evolution.

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Over the past 70 years, the incidence of syphilis has dramatically decreased and consequently the neurosyphilis one. Therefore, when a patient is presented with neuropsychiatric symptoms such as psychosis, mania, memory loss, neurocognitive troubles, attention defi cits, behavioral changes, or depression, a neurosyphilis diagnosis is not the fi rst that comes to a clinician's mind. In fact, many times, patients are fi rst treated with psychiatric medication when penicillin would be the appropriate line of treatment. In this article, after we review neurosyphilis, we report 11 clinical cases with neuropsychiatric manifestations of syphilis and make the case for careful syphilis screening in patients presenting with psychiatric and neurological symptoms.

We report the case of a 46-year old female with chronic hepatitis C virus infection who developed paresthesia and weakness of face and upper and lower extremities nine months after administration of peginterferon-alpha 2a. Considering her clinical evolution, neurological examination and nerve conduction studies, she was diagnosed with multifocal motor neuropathy related to peginterferon-alpha treatment. The patient recovered after use of intravenous immunoglobulins. From our knowledge there is no data in the literature about multifocal motor neuropathy related to peginterferon-alpha treatment. Doctors should be aware of this rare association, which requires immediate drug discontinuation and early management.