Table of Contents
Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Cerebral Cortex | 4A0 Case 4 History
Case 4 History ---- The patient was a 58 year-old female with a history of relapsing-remitting multiple sclerosis (RRMS) diagnosed in 1982 and which later became progressive until her death 25 year later. The patient's symptoms began with a right hemi-sensory deficit which remitted. The diagnosis was based on MRI and abnormal evoked potentials. The patient had a high IQ at baseline and was originally employed in a professional capacity. Her course was complicated by cognitive decline, which began in 1984, and depression, which was treated with Prozac for 5-6 years. The patient suffered a progressive decline in cognition after 1985. She had another attack in April 1996, with worse cognition, but also numbness from waist down and ataxia and nystagmus, dysdiadochokinesis bilaterally in her upper extremities, decreased strength in left lower extremity, increased tone (spasticity) in bilateral lower extremities, and numbness in bilateral lower extremities level about L1-2 on exam. She was in a nursing home at the time of her death. The patient was diagnosed with secondary progressive multiple sclerosis (SPMS) at time of death.
