By Paul S. Giacomini
This handbookis a suite of scientific narratives that underscore the heterogeneous and unpredictable presentation of a number of sclerosis (MS) and provides real-world medical context to contemporary drug advancements. This available and concise e-book is meant for use by way of a variety of doctors, from expert neurologists to scientific trainees with an curiosity in neurology. a great scientific source, Case reports in a number of Sclerosis presents an evidence-based dialogue of every case, with an goal to reinforce potent analysis and remedy of sufferers with MS and MS-related conditions.
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Additional info for Case Studies in Multiple Sclerosis
Uhthoff W. Untersuchungen uber die bei der multiplen Herdsklerose vorkommenden Augenstorungen. Arch Psychiatr Nervenkr. 1890;21:303-420. German. Frohman TC, Davis SL, Beh S, Greenberg BM, Remington G, Frohman EM. Uhthoff‘s phenomena in MS--clinical features and pathophysiology. Nat Rev Neurol. 2013;9:535-540. [Long-lasting and isolated Uhthoff‘s phenomenon after effort preceding multiple sclerosis]. Rev Neurol (Paris). 2010;166:61-65. French. Rio J, Porcel J, Tellez N, et al. Factors related with treatment adherence to interferon beta and glatiramer acetate therapy in multiple sclerosis.
After his initial optic neuritis he was found to have multiple lesions consistent with demyelination without enhancement on his MRI of the brain, as well as oligoclonal bands in his cerebrospinal fluid (CSF). He received intravenous (IV) methylprednisolone, with incomplete recovery of his vision. He was started on maintenance injectable therapy. His disease course has been complicated by multiple exacerbations. Over the last few months, he experienced separate episodes of new gait impairment, bilateral leg weakness and sensory loss, bladder incontinence, and sexual dysfunction.
Clinical pearls • DMTs should be offered to all patients when they are newly diagnosed with RRMS. • DMTs approved for the treatment of RRMS decrease the number and severity of relapses and decrease the accumulation of new lesions on the MRI, thereby potentially reducing disability progression over time. • The selection of a specific DMT for a patient is a highly individualized process and takes into account disease severity, patient’s history and preferences, efficacy, side-effect profile, and potential long-term treatment complications.