21-year-old female with an acute onset of a unilateral sixth cranial nerve deficit. Brain MRI showed at least a dozen white matter lesions, one of them contrast-enhancing. Sensory evoked potentials showed a bilateral increase in latency. Multiple sclerosis was diagnosed, and the patient was treated by corticosteroids, followed by improvement of symptoms. The first follow-up revealed no focal neurological signs with a history of a transitory unilateral lower limb hyposthenia. On the second visit, a horizonto-rotatory nystagmus and irregular paraesthesia in the right toes are documented.
43-year-old female with history of continued cigarette smoking and complaints of palpitations. A sinus tachycardia of 160 is documented with little physical activity. Pulmonary function studies revealed obstructive ventilatory defects, consistent with the smoking or beta blockers. She has been documented to have moderate mitral regurgitation, consistent with prior rheumatic disease. At the present time, she is on Inderal.