Levamisole is an immunomodulatory drug which can trigger development of levamisole-induced multifocal inflammatory leukoencephalopathy (LIMIL) in patients treated for helminthic invasion, aphthous stomatitis, cancer, or cocaine users. LIMIL clinical case in patient 45 years old after single dose of levamisole (taken without any medical prescription) was described. We presented clinical history and clinical picture, MRI and laboratory data and treatment results during 1-year observation. According to similarity of LIMIL with acute disseminating encephalomyelitis or debut of multiple sclerosis and high frequency of levamisole usage in Russia (usually without medical prescription) LIMIL should be included in differential diagnosis in demyelinating disorders and treated according to current clinical recommendation.

We have examined 72 patients aged from 18 till 62 with cerebral and cerebrospinal multiple sclerosis (MS) form. All patients have been underwent оtoneurologiс examination, electronystagmography (ENG), caloric tests, pure-tone audiometry, high frequency audiometry up to 20 kHz, impedance audiometry, auditory brainstem responses (ABR), magnetic resonance imaging (MRI). 59 patients had pathologically changed in MRI demyelination lesion in the brainstem. Demyelinization of the brainstem affects acoustical and vestibular function in patients with multiple sclerosis. Pathological changes of pure-tone audiometry, high frequency audiometry, acoustic reflexes and ABR may be regarded as subclinical signs of demyelinization of the cochleovestibular analyzer.