8/15 MR with Dr. Lorenzana: Multiple sclerosis

A young gentleman with a pmh of HTN who presents with 3 days of progressive left sided loss of sensation involving both his arm and leg with an MRI demonstrating 5 discrete white matter lesions who was ultimately diagnosed with MS.  He initially received IV steroids for the flare, ended up requiring plasma exchange.
**Emergent treatment of MS is steroids!  If refractory to steroids, then can use plasma exchange, which this patient ultimately required.
**Oligoclonal IgG bands are suggestive of MS though not a requirement for diagnosis
**Forms of MS are variable: Relapsing/Remitting, Secondary-Progressive, Primary-Progressive, and Progressive Relapsing
**The most common long term therapies for MS are interferon beta-1b or glatiramer.
**These patients should be on high dose Vitamin D which has been shown to prevent development of white matter lesions
 
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