title: Unusual primary manifestations of multiple sclerosis.
abstract: OBJECTIVE
  The aim of this study is to describe patients with unusual symptoms that were primary manifestations of multiple sclerosis (MS).
  
  
  METHODS
  We report 21 multiple sclerosis patients who presented unusual initial pictures (acute brachial pain n=4, headache n=6, ptosis n=1, oculomotor nerve palsy n=1, peripheral facial palsy n=1, throat pain n=1, hypoglossal nerve palsy n=1, visual field defect n=2, epilepsia n=2, and coma n=2) as the first manifestations in the absence of other obvious symptoms or signs.
  
  
  RESULTS
  Investigations demonstrated changes highly suggestive of multiple sclerosis on magnetic resonance imaging, cerebrospinal fluid analysis and electrophysiological tests. All cases completely or partially recovered after high-dose corticosteroid therapy. These patients have been followed up for 5 years.
  
  
  CONCLUSIONS
  In this study, we discuss possible correlations between clinical disturbances and neuroradiological abnormalities and show some rare or previously undescribed manifestations in multiple sclerosis.
authors.affiliation: Department of Neurology, Atatürk Trainingand Research Hospital, 35370, zmir, Turkey. yesim.yetimalar@gmail.com
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Yetimalar
authors.forename: Yaprak
authors.initials: Y
authors.lastname: Seçil
authors.forename: Ayşen Kendir
authors.initials: AK
authors.lastname: Inceoglu
authors.forename: Sölen
authors.initials: S
authors.lastname: Eren
authors.forename: Mustafa
authors.initials: M
authors.lastname: Başoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology; D003128:Coma / Q000453:epidemiology; D015897:Comorbidity; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000453:epidemiology; D004827:Epilepsy / Q000453:epidemiology; D005158:Facial Paralysis / Q000453:epidemiology; D005260:Female; D006423:Hemianopsia / Q000453:epidemiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008881:Migraine Disorders / Q000453:epidemiology; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000453:epidemiology*; D009886:Ophthalmoplegia / Q000453:epidemiology; D010146:Pain / Q000145:classification / Q000453:epidemiology; D013577:Syndrome