Clinical and Radiological Evaluation of Movement Disorders in Multiple Sclerosis

Document Type : Original Article

Authors

Neurology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446609

Abstract

Background: Movement disorders (MDs) are among the numerous symptoms of multiple sclerosis (MS), a neurodegenerative, inflammatory disease.
Aim of the work: We conducted this study to determine the prevalence of MDs in patients with MS (PwMS), to know the clinical type of MDs occurring with PwMS, and the MRI finding of those patients.
Patients and Methods: This was a cross-sectional study that screened PwMS between September 2022 and September 2024. We assessed the prevalence of MDs, their clinical phenotypes, and the MRI findings for those patients.
Results: Out of 320 screened PwMS, 76 (24%) experienced MDs. Mean age was 27.76; 58% were female, and 84% were urban residents. Most of the patients (64.5%) had one MD. The first exhibited MDs were as follows: ataxia (42%), extensor spasms (17%), tremors (13%), and restless legs syndrome (11%). The percentage of extensor spasms (3.9%) and ataxia (6.6%) decreased if presented as a second MD. All patients had periventricular lesions; juxtacortical (92%), cortical (32%), frontal subcortical (44%), and lentiform nucleus lesions (43%) were common. Bilateral lesions were frequent, especially in frontal subcortical regions (69.7%). Infratentorial lesions, mainly in the pons (66.2%), also involved the midbrain and cerebellum. We noted peri-ependymal brainstem lesions (38.1%) and cervical spine abnormalities (80.3%).
Conclusion: Our study revealed that MDs are prevalent among PwMS. Different MDs may occur including ataxia and RLS, and tremors. Additionally, we observed significant diversity in the location of MS lesions in the brain, which presumably contributes to the varied clinical presentations of the MDs.

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