{
  "abstract": "Multiple sclerosis (MS) is a chronic autoimmune demyelinating disorder primarily affecting the central nervous system, with cardiovascular autonomic involvement being a rare manifestation. We present a case of a patient who initially exhibited isolated Bell’s palsy without other neurological symptoms, later progressing to atrial fibrillation, hypertension, and hemiparesis. Magnetic resonance imaging revealed extensive demyelination across the cerebral hemispheres, brainstem, and notably, the area postrema. Given its anatomical positioning and neural connections, involvement of the area postrema suggests a potential role in neurogenic hypertension and cardiac arrhythmias. We propose that demyelination in this region contributed to the patient’s autonomic dysfunction. Additionally, we discuss the cerebral mechanisms underlying cardiac arrhythmias in MS and other neurological disorders. This case also highlights the uncommon presentation of isolated cranial neuropathies, such as Bell’s palsy, as an initial manifestation of MS and a potential indicator of disease relapse.",
  "authors": [
    {
      "affiliations": [
        "Neurology, Royal Perth Hospital, Perth, WA, Australia",
        "Neurology, Fiona Stanley Hospital, Perth, WA, Australia"
      ],
      "name": "Ravi Ambati"
    },
    {
      "affiliations": [
        "Neurosciences Unit, Perron Institute for Neurological and Translational Science, Perth, WA, Australia"
      ],
      "name": "David Prentice"
    }
  ],
  "title": "3663 A case report on multiple sclerosis associated with atrial fibrillation and neurogenic hypertension",
  "uid": "f2eb2563-fa57-5ef4-b078-64d1727097a7"
}