Summary

  • Demyelinating CNS condition clinically defined by 2 episodes of neurologic dysfunction (brain, spinal cord, or optic nerves) that are separated in space and time.
  • Classically presents in white women, aged between 20 to 40 years, with temporary visual or sensory loss. However, may affect either sex and any age or ethnic group, and may have variable neurological symptom location and/or duration.
  • May have subtle changes in vision, ambulation, and reflexes on examination that provide evidence of previous attacks (which may not have been noticed by the patient).
  • MRI brain is sensitive, but very susceptible to over-interpretation in the absence of clinical correlation. Spinal MRI is abnormal less often, but lends greater specificity when present with brain lesions.
  • Treatment of the condition can be divided into 3 parts: treatment of the acute attack; prevention of future attacks by reducing triggers and use of disease-modifying therapies; and symptomatic treatments of neurologic difficulties such as spasticity, pain, fatigue, and bladder dysfunction.

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