1 / 6

Practical Management of MS in the Primary Care Office Setting

Practical Management of MS in the Primary Care Office Setting. Case Study 2. Case 2: Diagnosis Presentation. Ms. K, a 35-year-old woman, awakened with numbness in her right leg and thorax to level of sternum About 1 week later she developed numbness and tingling in her left hand

mickey
Download Presentation

Practical Management of MS in the Primary Care Office Setting

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Practical Management of MS in the Primary Care Office Setting Case Study 2

  2. Case 2: DiagnosisPresentation Ms. K, a 35-year-old woman, awakened with numbness in her right leg and thorax to level of sternum About 1 week later she developed numbness and tingling in her left hand After about 2 weeks the symptoms began to decrease in intensity She presented for neurologic evaluation about 6 weeks after onset; symptoms had almost entirely resolved

  3. Case 2History Ms. K reports that about 15 months prior to current symptoms she had developed a headache, poor depth perception, and balance difficulties A few days later she developed hearing loss in her right ear and right facial numbness She was evaluated by ENT who ordered brain MRI Neurologic symptoms resolved about 3 weeks after onset She was never told the MRI results

  4. Case 2Physical Examination • General examination and mental status are normal • Visual acuity: 20/20 both eyes • Cranial nerves: subtle flattening of right nasolabial fold, otherwise normal • Motor: 4/5 left hand intrinsics, otherwise 5/5 • Sensory: decreased pain/temperature on left vs right • Vibration decreased bilateral great toe • Coordination and gait: normal • Reflexes: 1+ right upper extremity, 2+ left upper extremity, 4+ bilateral patellar, 3+ ankles, toes downgoing bilaterally

  5. Case 2MRI at Time of Second Event

  6. Case 2Discussion Questions • Does this patient meet McDonald criteria for MS? If not, what else is required? • What, if any, additional workup would you perform? • How would you counsel this patient? • Would you start treatment now?

More Related