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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Brainstem & Cerebellum | 12A0 Case 12 History
Case 12 History ---- The patient was a 45 year old woman with a history of multiple sclerosis. In January 1980 she started to have some numbness in the palm of the left hand progressing to tightness in her left chest and numbness of her right hand became numb. Her fingers and face tingled and she also had noticed urinary urgency.. She denied diplopia, loss of vision, tinnitus, trouble with hearing or facial weakness. She denied weakness of her arms and legs. There was no bowel problem. She had decreased fine motor function of her left hand but no real incoordination. At that time, on examination she was found to have a normal mental status and no evidence of aphasia. Visual acuity was 20/20 on the left and 20/25 on the right. Her fields were normal. Her fundi showed some medial disk blurring, but no real pallor. Her pupils were equal and reacted to light and accommodation. Facial sensation was symmetrical and present. Her face showed no weakness on either side. Speech was normal and swallowing was intact. Tongue protrusion was normal. Her gait showed normal heel, toe, tendon, and hopping motions. She had normal strength in upper extremities, proximal and distal, and she had mild proximal weakness of her left lower extremity with a grade 4 out of 5. Coordination was intact on fingers to nose and heel to shin testing. She had normal pin sensation and vibratory and position senses in all four extremities with absent abdominal reflexes. The clinical history since 1980 is not available. Terminally, the patient developed pneumonia and expired in November 1996.
