In recent years, in the pathogenesis of multiple sclerosis, emphasis has been placed on mitochondrial processes that influence the onset of the disease. Oxidative stress would be one of the consequences of mitochondrial dysfunction, and its impact on brain tissue is well described. Microglia, as a brain macrophage, have an important function in removing unwanted metabolites, as well as iron, which is an amplifier of oxidative stress. There are novelties in terms of the connection between these processes, which have redirected research more towards the process of neurodegeneration itself, so that the emphasis is no longer on neuroinflammation, which would initiate the pathological process itself and still exist in the vicinity of lesions with reduced intensity. The aim of this review is to summarize the current knowledge from the literature regarding oxidative stress, mitochondrial dysfunction and iron metabolism and how microglia are involved in these processes in multiple sclerosis.

Neurological and/or psychiatric signs and symptoms can characterizes the clinical picture of encephalopathy associated with autoimmune thyroid diseases and high levels of serum antithyroid autoantibodies. To the best of our knowledge, the literature does not include data on neurological abnormalities in patients with autoimmune thyroid diseases without encephalopathy. Therefore, the aim of this study was to analyze the neurological signs and symptoms that are not associated with a previously identified disease in patients with autoimmune thyroid diseases. This study included 66 patients who were diagnosed with autoimmune thyroid disease. Before the neurological examination, a detailed history of neurological symptoms was obtained for each patient. No neurological symptoms had been present before the test in 47 of 66 patients (71%). Of the remaining 19 patients (29%), 13 of 66 (20%) patients had headache. Among patients with headache, the concentrations of thyroid peroxidise antibodies were slightly higher than in patients without headache, though the difference was not statistically significant (p=0.380, Mann-Whitney test). The patients who took part in this study complained of other neurological symptoms including vertigo (two patients, 3.0%), tingling of hands (two patients, 3.0%), transient weakness of one leg (one patient, 1.5%) and forgetfulness (one patient, 1.5%). Electroencephalography was performed only in patients with neurological symptoms and was normal in all of these patients. Hashimoto encephalopathy is probably not as rare as predicted, but, among our patients with autoimmune thyroid disease, we did not recognize any patients meeting the required diagnostic criteria for encephalopathy. Some of our patients had headache, which was not linked with any previously identified disease.

We reported a case of a 22-year-old male patient with swallowing difficulties and double vision. He was diagnosed on the basis of a positive pharmacological test, damage to the postsynaptic neuromuscular junction and computed tomography of the thorax. Tests for antibodies targeted to acetylcholine receptors and to muscle-specific tyrosine kinase were negative. A partial improvement in neurological findings following treatment with pyridostigmine bromide, cyclosporine and methylprednisolone was notedadministered. Th e patient responded favourably to plasma exchange with a withdrawal of all clinical symptoms, confirming the hypothesis that humoral factors may underlie the pathogenesis of double-negative MG .

Introduction. Marchiafava-Bignami disease is a rare disorder mostly associated with chronic heavy alcohol consumption that results in progressive demyelination and necrosis of the corpus callosum. Case report. We reported a 35-year-old woman with a history of alcohol consumption and malnutrition. Neurological examination revealed axial hypotonia, dysarthric speech and lack of motor coordination. The brain multislice computed tomography imaging demonstrated hypodense lesion of the corpus callosum. On the basis of her history, clinical features and imaging studies, the diagnosis of an acute form of Marchiava-Bignami disease was made. Definite diagnosis was confirmed at autopsy. Conclusion. Marchiafava-Bignami disease is of a medical emergency and early recognition and early aggressive treatment are critical for a good clinical outcome. To our knowledge, this is the first case of Marchiafava-Bignami disease presented with axial hypotonia.