Prevalence and radiological characteristics of movement disorders among patients with multiple sclerosis: An observational study

• Movement disorders (MDs) are prevalent among patients with multiple sclerosis (PwMS), as evidenced by 76 out of 320 patients reporting MDs in this study. • MRI scans of the supratentorial area always showed periventricular lesions as the most common type of damage. There were also high rates of juxtacortical (92%), frontal subcortical (44%), and lentiform nucleus (43%). We commonly noted bilateral subcortical lesions, particularly in the frontal region (69.7%). • Infratentorial MRI lesions predominantly affected the pons (66.2%), midbrain, and cerebellum, with a constant left-right distribution. • In 80.3% of patients, the cervical spine MRI revealed lesions, indicating significant involvement outside the brain. • The broad variable lesion distribution is associated with the many clinical manifestations observed in MDs related to multiple sclerosis. Multiple sclerosis (MS) is a neurodegenerative, autoimmune inflammatory illness with diverse symptoms, including movement disorders (MDs). Thus, we aimed to identify the prevalence and radiological findings of movement disorders (MDs) experienced by patients with multiple sclerosis (PwMS). We conducted a cross-sectional study on MS patients who reported MDs between September 2022 and March 2024. We reported the MRI findings of movement disorders that occur in PwMS. Among 330 screened MS patients, 76 (58% female, mean age 27.76 years) had MDs. All patients showed periventricular lesions, with significant percentages displaying juxtacortical (92%), cortical (32%), frontal subcortical (44%), and lentiform nucleus lesions (43%). Parietal, temporal, and occipital subcortical lesions were less common. Bilateral lesions were prevalent across most subcortical areas, notably in the frontal subcortical region (69.7%). Less frequently affected areas included the caudate nucleus, internal capsule, thalamus, and subthalamus, with varying laterality. Infratentorial lesions, mainly in the pons (66.2%), also involved the midbrain and cerebellum, with a balanced left-right distribution. Peri-ependymal brainstem lesions occurred in 38.1%, and cervical spine abnormalities in 80.3%. This study emphasizes the frequency and radiological features of MDs in PwMS. The MRI results indicate a widespread and varied distribution of lesions, which aligns with the range of clinical symptoms observed in MS patients.