Condition Info - BotMed Application

ConditionName

Multiple sclerosis (MS)

ConditionDescription

Symptoms

Onset is often in third or fourth decade of life;
Multiple neurological deficits of CNS;
Affects any aspect of CNS;

Most common presentation:
Blurry vision;
Visual disturbance from optic neuritis;
Inability to adduct one eye and another eye has nystagmus;

Fatigue;
Spasticity and hyperreflexia;
Cerebellar deficits;
Stiffness and weakness of muscles,

Difficulty with cognition;
But almost NO dementia;
Sex dysfunction;

Urinary symptoms;

Optic neuritis: eye pain that worsens with eye movement;
Central vision loss;

Brain fog;

PhysicalFindings

Can have no other findings can have other neurological symptoms;
Afferent pupillary defect:
No constriction with direct light, constriction of both pupils with indirect light;

Internuclear ophthalmoplegia;
Eye on the side of the lesion can’t adduct;
Contralateral eye has nystagmus;

Lhermitte's sign (pronounced Ler-meets) is a sudden sensation resembling an electric shock that passes down the back of your neck and into your spine and may then radiate out into your arms and legs. It is usually triggered by bending your head forward towards your chest.

Problem with coordination;
Tremor; 
Tightness around ribs;
Ribs contraction;

ClinicalTests

Most accurate and best initial test: MRI;

MRI shows new, multiple white matter hypodense lesion: progressive multifocal leukoencephalopathy (PML);

Initial diagnostic test: CSF;
Mild elevation in protein;
<50-100 WBC:
Oligoclonal bands found in 85% of MS;

CSF:
↑Protein;
↑mildly increased WBC;
Oligoclonal bands;

R/O:  Vitamin B12 deficiency may mimic MS;

RiskFactors

More common in white women living in colder climates;
Female 20-40;

IsRedFlag

IsNPLEX

Consequence

ProgressionFromCondition

Optic neuritis;

TreatmentOptions

PharmOptions

Best initial therapy: high dose steroids

Drug that prevent relapse and progression:
Beta-interferon
Glatiramer acetate

WebLink

https://www.merckmanuals.com/professional/neurologic-disorders/demyelinating-disorders/multiple-sclerosis-ms?query=Multiple sclerosis