Click here to watch Dr. Jiwon Oh discuss the case and your responses to the quick poll.
Ellen is a 48-year-old elementary teacher with a history of migraine dating back to her twenties. She is perimenopausal with hot flashes and fatigue, and a recent increase in migraine frequency to 5-6 headaches per month. Her family physician diagnosed depression two years ago and started Ellen on a trial of sertraline. Read More
Click here to watch Dr. Virginia Devonshire discuss the case and your responses to the quick poll.
Michael P. is a 55-year-old male diagnosed with relapsing MS five years ago. He presented with a spinal cord relapse that resulted in residual sensory and mild bladder dysfunction in his lower limbs and EDSS 2.5. His MRI had a thoracic lesion and more than 10 brain lesions meeting McDonald 2017 criteria. He was started on teriflunomide 14 mg/day but reported poor tolerability. Read More
Click here to watch Dr. Dalia Rotstein discuss the case and your responses to the quick poll.
A 51-year-old woman presents with lower extremity weakness and numbness which began 24 hours ago and gradually ascended up to her mid-chest. She could not ambulate for the last 12 hours, and it is more difficult to pass urine. She has no history of recent infectious symptoms or travel. Read More
P.B. is a 57-year-old woman with a 24-year history of relapsing-remitting multiple sclerosis. She was treated with an injectable from 2002-2012. Her last relapse was in 2009. She was transitioned to fingolimod in 2012 because of ongoing MRI changes and increasing tolerability issues. Read More
Click here to watch Dr. Courtney Casserly discuss the case and the responses to the survey.
J.M. is a 28-year-old woman who had an MRI of the brain ordered by her nurse practitioner because of worsening of longstanding migraine headaches. The MRI demonstrated several lesions consistent with MS including two small enhancing lesions and multiple nonspecific supratentorial T2 hyperintensities. Your review of the history reveals nothing suggestive of a demyelinating episode. There is no family history of MS. She has an older brother with ulcerative colitis. The neurological examination was completely normal with borderline questionable pallor of the left optic disc.