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Multiple Sclerosis – USMLE Diagnosis With Tingling and Hemiparesis

Information about Multiple Sclerosis:

In this video I illustrated a disease that should always be recognized early on – Multiple Sclerosis! This disease sadly cannot be cured but it can be diagnosed and treated early on. This can really improve the patients life quality and reduce the symptoms. But at least for me and I believe for many other younger doctors recognizing such general symptoms and assuming that it’s MS can be really challenging. I hope these illustrations help ! Take care..

Posted by Symptomsky – Medical Chat & USMLE-prep on Monday, September 25, 2023

Multiple Sclerosis – USMLE Diagnosis With Tingling and Hemiparesis

Multiple sclerosis is a chronic and long-lasting disease of the central nervous system, particularly the neurons. It is thought to be an autoimmune disease that is inflammatory in nature, inflaming the myelin sheath (the protective insulating layer) around the axons of neurons, forming scar tissue called sclerosis. It is an unpredictable disease that affects people differently, particularly women between the ages of 15 to 45.

Its causes are multiple; it can be an autoimmune disorder, environmental or genetic factors, and infectious agents. Symptoms are categorized into primary, sensory, motor, and cerebellar dysfunction. Primary symptoms include fatigue, weakness, and retrobulbar neuritis. In motor dysfunction, patients experience spastic, mono, hemi, or paraparesis. Sensory symptoms include loss of sensation, hearing loss, blurred or double vision, pain, numbness, prickling, or pins and needles (paresthesia). Normal cerebellar functions like coordinated movements of the body are also disturbed, with walking ataxia, nystagmus (rapid involuntary movements of the eye), and intentional tremors (rapid, involuntary, back and forth movements of any limb when we act). General symptoms like bowel and bladder problems, erectile dysfunction, and urinary retention also occur due to loss of motor function.

Coming to its differential diagnosis, multiple sclerosis can be differentiated from Neuromyelitis optica, chronic neuroborreliosis, neurosyphilis, AIDS, and SLE with neurologic presentation on the basis of MRI and the above-stated symptoms.

Treatment is different for different patterns of this disease. For acute attacks of multiple sclerosis, we use glucocorticoids as a therapy option. In the mild form of multiple sclerosis, immunomodulators (such as Glatiramer acetate sc) and immunosuppressants like IFN-beta are the options available, while its severe form is treated with Cladribine po, Fingolimod po, and Natalizumab iv.

The prognosis for multiple sclerosis can vary widely from person to person and is influenced by factors such as its type, the age and onset, and most importantly, the individual response to treatment.

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Symptomsky - USMLE Differential Diagnosis

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