Sum maryObjective: Currently cognitive dysfunction is recognized as a significant cause of disability in multiple sclerosis (MS). The Montreal Cognitive Assessment (MOCA) test is a screening device used to evaluate executive functions, visuo-spatial abilities, language, attention, and concentration, abstract thinking, memory, and orientation domains. The aim of this study is to compare cognitive functions of MS patients with age-matched controls using MOCA test. Ma te ri al and Met hod: Thirty-nine subjects with a diagnosis of relapsing-remitting MS based on the 2010 revised McDonald criteria and 20 healthy volunteer controls participated in this study. Patients and controls were administered the Turkish version of MOCA test. Total and subgroup scores were compared. Re sults: Total MOCA score in MS patients and controls were 21.74±4.48 and 26.9±2.53, respectively. Total MOCA score of MS patients was significantly lower than controls (p=0.000). Significant deterioration was also found in language, attention, memory and executive functions domains. Disease duration and expanded disability status scale (EDSS) did not differ in patients with and without cognitive deficits. Dis cus si on: Patients with MS showed deterioration in language, attention, working and long term-memory and executive functions compared to controls. MOCA is a simple, stand-alone cognitive screening test with superior sensitivity. Our findings suggest that the MOCA test may be useful for screening cognitive impairment in MS patients early in the disease course.

The most frequent health problems seen in senility are chronic and degenerative diseases. A 75-year-old male patient with the complaints of weight loss and difficulty in swallowing was admitted to our hospital from a nursing home. Upper system fiber-optic gastrointestinal endoscopy was performed and a mass at the junction of the hypopharynx and esophagus just below recessus piriformis obstructing almost the whole of the lumen and blocking the distal passage was detected. Computed tomography revealed marked narrowing secondary to osseous hypertrophy in the air column of the hypopharynx and proximal esophagus. Diffuse idiopathic skeletal hyperostosis or Forestier's disease is an idiopathic disease characterized by the ossification of the anterior longitudinal ligament of vertebra and some of the extraspinal ligaments. In the present case we aim to discuss an elderly patient who suffered from dysphagia and weight loss and the diagnostic stages.

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