Visual and Motor Changes in Patients With Multiple Sclerosis

Guthrie, Thomas C.

doi:10.1001/archneurpsyc.1951.02320040027002

Cited by 68 publications

(10 citation statements)

References 17 publications

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“…Blood pressures, visual acuity, pupillary size, dysarthria, nystagmus, range of extraocular movements, and evidence of weakness of the extremities were recorded. A previous study (Nelson et al, 1958) indicated that the most frequent neurological changes were diminished visual acuity and changes in extraocular movements, and led us to concentrate on these observations. Changes in reflexes, strength, coordination, etc., may have occurred during this study but due to their inconsistent change in the first study and difficulty in evaluating and recording them, they were not included.…”

Section: Methodsmentioning

confidence: 94%

“…Simons (1937) pointed out that 62% of patients with multiple sclerosis gave a history of becoming weak when exposed to heat. Guthrie (1951) found that neurological signs can develop in a patient with multiple sclerosis when only a leg or arm is immersed in hot water, and he pointed out the frequent diminution in visual acuity and the appearance of scotomata when patients are totally or partially immersed in hot water.…”

mentioning

confidence: 99%

“…In an earlier study (Nelson, Jeffreys, and McDowell, 1958), we investigated the effects of induced hyperthermia by hot baths not only on patients with multiple sclerosis but on patients with a variety of other diseases of the nervous system. It was found that each of the 12 patients with multiple sclerosis developed neurological changes and that these were usually multiple (an average of 2-8 per patient).…”

mentioning

confidence: 99%

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The Effects of Induced Hyperthermia on Patients With Multiple Sclerosis

Nelson¹,

McDowell²

1959

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Methodsmentioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Effects of Induced Hyperthermia on Patients With Multiple Sclerosis

Nelson¹,

McDowell²

1959

Journal of Neurology, Neurosurgery & Psychiatry

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“…The circadian change in body temperature also a¡ects some patients (Namerow 1968;Davis et al 1973). The deleterious e¡ects of warming occur promptly, such that a patient may require support to prevent drowning in a hot bath (Guthrie 1951). Indeed, a fatal case of scalding has been described (Waxman & Geschwind 1983), together with deaths from hyperthermia during sunbathing: the patients were believed to have been prevented from moving into the shade by weakness induced by body warming (Harbison et al 1989;Avis & Pryse-Phillips 1995).…”

Section: E¡ects Of Temperaturementioning

confidence: 99%

The pathophysiology of multiple sclerosis⋮ the mechanisms underlying the production of symptoms and the natural history of the disease

Smith

McDonald

1999

Phil. Trans. R. Soc. Lond. B

288

181

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The pathophysiology of multiple sclerosis is reviewed, with emphasis on the axonal conduction properties underlying the production of symptoms, and the course of the disease. The major cause of the negative symptoms during relapses (e.g. paralysis, blindness and numbness) is conduction block, caused largely by demyelination and inflammation, and possibly by defects in synaptic transmission and putative circulating blocking factors. Recovery from symptoms during remissions is due mainly to the restoration of axonal function, either by remyelination, the resolution of inflammation, or the restoration of conduction to axons which persist in the demyelinated state. Conduction in the latter axons shows a number of deficits, particularly with regard to the conduction of trains of impulses and these contribute to weakness and sensory problems. The mechanisms underlying the sensitivity of symptoms to changes in body temperature (Uhthoff's phenomenon) are discussed. The origin of ‘positive’ symptoms, such as tingling sensations, are described, including the generation of ectopic trains and bursts of impulses, ephaptic interactions between axons and/or neurons, the triggering of additional, spurious impulses by the transmission of normal impulses, the mechanosensitivity of axons underlying movement–induced sensations (e.g. Lhermitte's phenomenon) and pain. The clinical course of the disease is discussed, together with its relationship to the evolution of lesions as revealed by magnetic resonance imaging and spectroscopy. The earliest detectable event in the development of most new lesions is a breakdown of the blood–brain barrier in association with inflammation. Inflammation resolves after approximately one month, at which time there is an improvement in the symptoms. Demyelination occurs during the inflammatory phase of the lesion. An important mechanism determining persistent neurological deficit is axonal degeneration, although persistent conduction block arising from the failure of repair mechanisms probably also contributes.

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“…This method of visual assessment has the two following advantages: (1) There is a relatively sharp "cut-off" for an accurate and reproduceable endpoint. (2) The visual endpoint can be rapidly determined.…”

Section: Steam Onmentioning

confidence: 99%

Temperature Effect on Critical Flicker Fusion in Multiple Sclerosis

Namerow¹

1971

Archives of Neurology

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Eighteen multiple sclerosis (MS) patients with a history of optic neuritis and ten normal subjects had the visual critical flicker fusion frequency (CFF) determined prior to and during exposure to moist hot air. Central temperature was monitored by a thermocouple placed against the tympanic membrane. The patients demonstrated a dramatic fall in CFF on exposure to heat, while normals showed a slight rise in CFF. The effect was frequently exquisite: in one instance a 40% fall in CFF was correlated to a 0.2 C rise in central temperature. The effect was also quite rapid with a statistical difference between the normal and patient responses noted within two minutes after heat exposure. During this time there was little demonstrable change in central temperature. Prediction curves for the CFF change of heated patients and normals were also calculated.

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Visual and Motor Changes in Patients With Multiple Sclerosis

Cited by 68 publications

References 17 publications

The Effects of Induced Hyperthermia on Patients With Multiple Sclerosis

The Effects of Induced Hyperthermia on Patients With Multiple Sclerosis

The pathophysiology of multiple sclerosis⋮ the mechanisms underlying the production of symptoms and the natural history of the disease

Temperature Effect on Critical Flicker Fusion in Multiple Sclerosis

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