Despite the common belief that multiple sclerosis (MS) is a painless disease, several studies contradict this. There are a significant number of MS patients who actually suffer from painful conditions such as central and peripheral neuropathy, migraines, trigeminal neuralgia, painful tonic spasms, complex regional pain syndrome, glossopharyngeal neuralgia, and transverse myelitis. In addition, MS relapses are usually painful with many patients complaining of paroxysmal dystonia and neuropathic pain during these episodes. Additionally, treatments for MS such as use of beta-interferons may be associated with headache and pain at the injection site. The pathophysiology of pain in MS is poorly understood, but may be related to the development of demyelinating lesions involving certain neuroanatomic pathways such as the spinothalamic tract. Management of pain in MS patients is a therapeutic challenge for clinicians. Currently, various pharmacological agents such as antiepielptics, non-steroidal anti-inflammatory agents, and even corticosteroids are used to suppress various painful conditions associated with MS. Non-pharmacological procedures such as massage therapy have also been used in the treatment of MS patients. The authors present a review of recent findings in pathophysiology and management of pain in MS patients.

Our research examines the use and potential of native web technologies for musical expression. We introduce two JavaScript libraries towards this end: Gibberish.js, a heavily optimized audio DSP library, and Interface.js, a GUI toolkit that works with mouse, touch and motion events. Together these libraries provide a complete system for defining musical instruments that can be used in both desktop and mobile web browsers. Interface.js also enables control of remote synthesis applications via a server application that translates the socket protocol used by web interfaces into both MIDI and OSC messages.

IntroductionGlossopharyngeal neuralgia is an uncommon, painful syndrome, characterized by paroxysms of pain in the sensory distribution of the 9th cranial nerve. Idiopathic glossopharyngeal neuralgia may be due to compression of the glossopharyngeal nerve by adjacent vessels, while secondary glossopharyngeal neuralgia is associated with identifiable lesions affecting the glossopharyngeal nerve at different levels of its neuroanatomic pathway. Glossopharyngeal neuralgia is rare in the general population, but is more common in patients with multiple sclerosis.Case presentationA 56-year-old Caucasian woman with multiple sclerosis and migraine presented to our facility with intermittent lancinating pain to the right of her throat, tongue, and the floor of her mouth that had been occurring for the past year. The pain was intense, sharp, and stabbing, which lasted two to six seconds with radiation to the right ear. Initially, the attacks were infrequent, however, they had become more intense and frequent over time. Our patient reported weight loss, headache, painful swallowing, and the inability to maintain sleep due to painful attacks. A neurological examination revealed a right-handed woman with trigger points in the back of the tongue and throat on the right side. She also had dysphagia, hoarseness, and pain in the distribution of the right glossopharyngeal nerve. Mild right hemiparesis, hyperreflexia, dysmetria, and an ataxic gait were present. A magnetic resonance imaging scan of the brain was consistent with multiple sclerosis and magnetic resonance angiography demonstrated a loop of the posterior inferior cerebellar artery compressing the right glossopharyngeal nerve. She responded satisfactorily to carbamazepine. Microvascular decompression and Gamma Knife® radiosurgery were discussed in case of failure of the medical treatment; however, she declined these options.ConclusionsGlossopharyngeal neuralgia in multiple sclerosis may occur due to vascular compressive lesions and it should not be solely attributed to the underlying demyelinating process. Vascular compression of the glossopharyngeal nerve could independently cause glossopharyngeal neuralgia in patients with multiple sclerosis, and vascular imaging to exclude such a diagnosis is recommended.

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Many data sets contain structural 3D components along with associated textual data. While structural data is often best visualized on large stereoscopic displays, such displays can pose problems presenting accompanying textual information. Chief among these problems is a tradeoff between size dependent legibility of text and the occlusion of structural data if text is presented at larger sizes. Our solution to this problem integrates structural data shown on a large display while users select features of the structure and view the associated textual data on personal tablets.Our solution also lends itself to collaborative browsing tasks. In our initial implementation each user can individually select structural components and view the associated text on their own tablet; thus, everyone becomes an active participant in data mining. When individual users find textual data they deem of interest to the group they can share it with collaborators by temporarily pushing the text box to the large display. The current status and each individual's browsing history are shown on the large display in order to provide awareness of other team members' actions.

We describe design decisions informing the development of Gibber, an audiovisual programming environment for the browser. Our design comprises a consistent notation across modalities in addition to high-level abstractions affording intuitive declarations of multimodal mappings, unified timing constructs, and rapid, iterative reinvocations of constructors while preserving the state of audio and visual graphs.We discuss the features of our environment and the abstractions that enable them. We close by describing use cases, including live audiovisual performances and computer science education.

Native Web technologies provide great potential for musical expression. We introduce two JavaScript libraries towards this end: Gibberish.js, providing heavily optimized audio DSP, and Interface.js, a GUI toolkit that works with mouse, touch, and motion events. Together they provide a complete system for defining musical instruments that can be used in both desktop and mobile Web browsers. Interface.js also enables control of remote synthesis applications via a server application that translates the socket protocol used by Web interfaces into both MIDI and OSC messages. We have incorporated these libraries into the creative coding environment Gibber, where we provide mapping abstractions that enable users to create digital musical instruments in as little as a single line of code. They can then be published to a central database, enabling new instruments to be created, distributed, and run entirely in the browser.

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