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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Optic Nerves | 6A0 Case 6 History
Case 6 History ---- The patient was a 50 year old woman with a history of relapsing/remitting MS for the last 13 years, and questionable secondary progression late in the course of her illness. Most of her neurological complaints were localized to the spinal cord. For the last three years of her life the patient was home- and wheelchair-bound. The patient was seen approximately one year prior to her death at which time she was found to have fatigue, leg swelling, nausea, vomiting, urinary incontinence (most likely caused by atonic bladder related to her myelopathy), weakness, double vision, numbness, falling episodes, and depression. She began a trial of Gilenya. Near the time of her death the patient developed new symptoms including headache, vomiting, and generalized weakness culminating in a short series of seizures. Following the seizures, the patient's husband observed cognitive changes in the patient that never resolved and were not present prior to the seizures; at that time she lost all lower extremity muscle tone. Brain and spinal cord MRI images demonstrated new lesions in the brain/brainstem and one in the spinal cord. She was discharged and died shortly thereafter
