Cardiovascular autonomic dysfunction is not uncommon in multiple sclerosis (MS) and is related to the involvement of the vegetative areas of cardiac innervations in the medulla oblongata. It has been suggested that this may contribute to the occurrence of sudden death in MS. In this case report, we present a patient with active relapsing–remitting MS who died unexpectedly due to the sudden onset of cardiac arrythmias. Post-mortem examination showed the presence of active demyelinating lesions in the medulla oblongata. As far as we know, this is the first case report clearly linking sudden cardiac death to active MS on the histopathological level.
PolmanCHReingoldSCEdanGFilippiMHartungHPKapposL. Diagnostic criteria for multiple sclerosis: 2005 revisions to the ‘McDonald Criteria’. Ann Neurol2005; 58: 840–846.
2.
AchironAKishnerIDolevMSternYDultizkyMSchiffE. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol2004; 251: 1133–1137.
3.
HaasJHommesOR. A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis. Mult Scler2007; 13: 900–908.
DrouinENatafSLandeSLouboutinJP. Abnormalities of cardiac repolarization in multiple sclerosis: relationship with a model of allergic encephalomyelitis in rat. Muscle Nerve1998; 21: 940–942.
6.
SaariATolonenUPääkköESuominenKPyhtinenJSotaniemiK. Cardiovascular autonomic dysfunction correlates with brain MRI lesion load in MS. Clin Neurophysiol2004; 115: 1473–1478.
7.
RiudavetsMAColegialCRubioAFowlerDPardoCTroncosoJC. Causes of unexpected death in patients with multiple sclerosis: a forensic study of 50 cases. Am J Forensic Med Pathol2005; 26: 244–249.
8.
BramowSFaber-RodJCJacobsenCKutzelniggAPatrikiosPSorensenPS. Fatal neurogenic pulmonary edema in a patient with progressive multiple sclerosis. Mult Scler2008; 14: 711–715.
