we confirmed the presence of anti-Kir4.1 antibodies in MS patients, but at a much lower prevalence than previously reported.

Status dystonicus is potentially reversible and a result of heterogeneous conditions with nonuniform underlying physiology. Recognition of the complex phenomenology, morphological alterations, and distinct patterns of evolution, before and after status dystonicus, will help our understanding of these conditions. © 2018 International Parkinson and Movement Disorder Society.

DWI has been described in some reports to be superior to FLAIR in early stage herpes simple virus encephalitis (HSE). Few data exist on detailed topographical MRI analysis in HSE. Our aim was to study DWI and FLAIR, and analyse topographically these sequences in non-neonatal HSE patients with MRI performed within 60 days. Eleven HSE patients were analysed retrospectively. For topographical analysis, we developed a radiological 50-point score (25 points for each hemisphere, with each point corresponding to a brain area). In patients with MRI performed within 2 weeks (n = 9), DWI detected 11% more areas involved than FLAIR. Thalamic involvement was frequent (67%) in the early phase on FLAIR, being the only brain substructure better visualized on FLAIR than on DWI. In areas involved on both sequences, DWI showed more extensive (especially cortical) abnormalities in 14% of the areas. In patients with late MRI (n = 2), FLAIR was superior to DWI (with essentially white matter involvement). From the mesial temporal area, brain signal changes followed a centripetal (i.e. towards anterior, posterior, and superior parts of the brain) gradient. The cut-off score before involving the contralateral hemisphere was 8-9/25 in the initially involved hemisphere. DWI is slightly superior to FLAIR in acute-subacute HSE, except for the thalamus with FLAIR signal changes more frequently seen than earlier reported. Knowledge of typical topographical MRI involvement can help to differentiate from other conditions mimicking HSE.

The high prevalence of ocular motor manifestations emphasizes the importance of neuro-ophthalmological examination among patients with MS. Because chronic manifestations may cause minimal or no symptoms, a systematic investigation of the most common manifestations should be performed in daily practice. Appropriate treatment may improve visual outcome in some of these ocular motor disorders.

Background: The most common causes of acquired pendular nystagmus (APN) are multiple sclerosis (MS) and oculopalatal tremor (OPT), both of which result in poor visual quality of life. The objective of our study was to evaluate the effects of memantine and gabapentin treatments on visual function. We also sought to correlate visual outcomes with ocular motor measures and to describe the side effects of our treatments. Methods: This study was single-center cross-over trial. A total of 16 patients with chronic pendular nystagmus, 10 with MS and 6 with OPT were enrolled. Visual acuity (in logarithm of the minimum angle of resolution [LogMAR]), oscillopsia amplitude and direction, eye movement recordings, and visual function questionnaires (25-Item National Eye Institute Visual Functioning Questionnaire [NEI-VFQ-25]) were performed before and during the treatments (gabapentin: 300 mg 4 times a day and memantine: 10 mg 4 times a day). Results: A total of 29 eyes with nystagmus were evaluated. Median near monocular visual acuity improved in both treatment arms, by 0.18 LogMAR on memantine and 0.12 LogMAR on gabapentin. Distance oscillopsia improved on memantine and on gabapentin. Median near oscillopsia did not significantly change on memantine or gabapentin. Significant improvement in ocular motor parameters was observed on both treatments. Because of side effects, 18.8% of patients discontinued memantine treatment—one of them for a serious adverse event. Only 6.7% of patients discontinued gabapentin. Baseline near oscillopsia was greater among those with higher nystagmus amplitude and velocity. Conclusions: This study demonstrated that both memantine and gabapentin reduce APN, improving functional visual outcomes. Gabapentin showed a better tolerability, suggesting that this agent should be used as a first-line agent for APN. Data from our investigation emphasize the importance of visual functional outcome evaluations in clinical trials for APN.