Q1

Are anticholinergics the first line of treatment for primary torsion

dystonia?

Q2

Can multiple sclerosis (MS) be associated with lack of vitamin D,

lack of sunlight or low fish/cod-liver oil in the diet? By looking at the

epidemiology (none at the equator; more outside 40 latitude, both north

and south; less on top of Swiss mountains than in the Swiss valleys; more

in fishing coastal towns and in Eskimos) this seems to be very important.

Vitamin D modulates the immune system and active vitamin D given

to rats with experimental MS (acute encephalomyelitis) lowers the

monocyte count in cerebrospinal fluid (CSF) by 90% in 72 hours with

return of power to their limbs. Japanese MS patients who ate plenty of

fish were found to have vitamin-D-receptor pleomorphism. The staple

grains and cereals (wheat, barley, oats) eaten in Scandinavian and

northern European countries contain phytic acid, which blocks vitamin D

absorption, and rice is the only cereal free of phytic acid.

Are there any studies where low vitamin D levels in blood are

associated with MS relapse?125

Q3

What are the diagnostic criteria of 'definitive' multiple sclerosis (MS) - as

taught to a medical student? We have found different information from

different sources.

Q4

How reliable is a CT-brain scan with contrast in showing MS lesions as

enhancing lesions in the presence of a contraindication to use MRI?

Q5

Is magnetic resonance (MR) spectroscopy of value in differentiating

multiple sclerosis from cerebral autosomal dominant arteriopathy with

subcortical infarctions (CADASIL)?

Q6

Is there evidence of the efficacy of cyclic pulse cyclophosphamide

therapy in the treatment of relapsing-remitting multiple sclerosis?

Q7

Glatiramer acetate and interferon-beta are recommended by some people

for the treatment of multiple sclerosis. Which drug should I use for a

patient with a 2-year history of relapsing-remitting MS.135

Q8

1. Most neurological books available to me say that high-dose IV

dexamethasone can be used in acute relapses of multiple sclerosis

(MS). What is the recommended dosage and regimen for this drug?

2. I understand that depot preparations of betamethasone (Depofos)

can also be used in acute relapses of MS, as well as treatment for

idiopathic Bell's palsy. If so, can you tell me the recommended dosage

and regimen for this drug?

Q9

What are the most common causes of chronic meningitis and what

investigations must be done?

Q10

What is Hib meningitis?