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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Brainstem & Cerebellum | 5A0 Case 5 History
Case 5 History ---- The patient was a 46 year old woman with a diagnosis of multiple sclerosis. Her first symptoms started at the age of 25 when she had numbness and tingling of the hands associated with incoordination and loss of hand grip. Three years later she had weakness of the left arm and leg associated with left-sided numbness which lasted 1 ½ weeks. At age 32, she developed paraparesis which has been progressive since then. At that time she was diagnosed with multiple sclerosis based on an MRI and CSF examination. She had been treated in multiple locations with IV Solumedrol and she had also been treated with Cytoxan for chronic progressive multiple sclerosis. An MRI of the brain in 1990 showed multiple white matter periventricular lesions. A repeat MRI of the brain in 1993 showed smaller lesions than before. Her last admission to the hospital was from 7/31/98 to 8/7/98 when she was admitted with lingular pneumonia, urinary tract infection, and corneal abrasions with reactive conjunctivitis. At the time a suprapelvic catheter and lumbar morphine pump were placed. On neurological exam she was alert and oriented x3. Her language was reportedly normal. Her fundi were normal. She had mild bilateral upper extremity weakness and she had marked paraparesis with only minimal hip flexion. She had diffuse hyperreflexia and upgoing toes. She had decreased sensation to pinprick and decreased vibratory and position sense in her lower extremities. She was unable to walk. She received a course of IV antibiotics and was discharged home improved. After this date there are no more records, but reportedly the patient expired in October 1998 at home.
