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D.C. is a 41-year-old woman diagnosed with multiple sclerosis 14 years ago. She was treated initially with a beta interferon. She experienced ongoing disease activity and was transitioned to natalizumab 10 years ago. She was completely stable for six years. She was switched to fingolimod after a significant change in JCV index. She had no MRI changes on natalizumab and a few new MRI lesions on fingolimod. She had no new lesions while on natalizumab and few MRI changes on fingolimod. Her EDSS score a year ago was 1.5 (vision 1, sensory 1, bladder 1). Read More

Click here to watch Dr. Kristen Krysko discuss the case and the responses to the survey.

RJ, age 38 years, has a 15-year history of relapsing-remitting multiple sclerosis. She initially presented with highly-active MS and was started on beta-interferon-1a 44µg. She continued to have significant clinical disease activity and ongoing MRI lesions in both brain and spine. She was transitioned to fingolimod in 2012. Read More

Click here to watch Dr. Virginia Devonshire discuss the case and the responses to the survey.

Thomas, 38, is a chemical engineer who initially presented in 2019 with optic neuritis followed two months later by a myelopathic episode. MRI was highly active with two gadolinium-enhancing T1 and multiple T2 lesions. EDSS was 2.5 (optic 1, sensory 2, bladder 2). Thomas had no relevant medical conditions other than obesity; his body weight was 120 kg (BMI 34 kg/m2) at presentation. Read More

Click here to watch Dr. Daniel Selchen discuss the case and the responses to the survey.

Ken, a 53-year-old man, was initially seen in 2017 following onset of painful spasms in R leg and probable clonus while driving his car. He developed R leg weakness and band-like discomfort across his chest. He was worked up for stroke and cardiac issues and all investigations were negative. He had a prior history of asthma with nasal polyps and NSAID-associated dyspnea.

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Click here to watch Dr. Julie Prévost discuss the case and the responses to the survey.

Michelle, 46, is a bank manager who was diagnosed with MS in 1996. She was initially treated with interferon-beta-1a 44 ug. She experienced ongoing clinical and radiological activity and was switched to natalizumab in 2013. She remained stable for seven years. In February 2020, Michelle noted that she used to be able to walk 2 km but could now only manage about 1 km. Her EDSS score showed no change over the past year. EDSS score was 3.0 (motor 2, cerebellar 2, sensory 2). She was started on 4-aminopyridine but obtained no benefit. Read More