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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Optic Nerves | 2A0 Case 2 History
Case 2 History ---- The patient was a 69 year old woman diagnosed with multiple sclerosis in 1976 when she originally presented with fatigue, foot and hand numbness, unsteady gait, and loss of bowel and bladder function. She reported decreased morning vision and sporadic diplopia, but no vision loss. Physical examination at that time showed 4 and 5/5 strength in the lower and upper extremities, respectively. Distal vibration sense and position sense were absent. Her gait was described as "wobbly." Her visual acuity was 20/20. The remainder of the neurological examination was unremarkable. Her weakness progressed until 1983, at which time she became wheelchair bound after a fall with ankle fracture. Over this time she was hospitalized several times for recurrent MS and was treated with ACTH or Solumedrol. Her last documented visit was in September, 1996, at which time she was quadriplegic and dysarthric. She reported being able to read with glasses. Physical exam showed a left head tilt and triplegia with a left arm strength of 3/5. The circumstances surrounding her death were not available.
