Click here to watch Dr. Daniel Selchen discuss the case and the responses to the survey.
Craig is a 36-year-old salesperson with no prior medical history. In 2012, he presented with optic neuritis. Six months later he experienced a myelopathic episode. MRI-brain and -C-spine revealed a moderate disease burden of seven T2 lesions and one Gd+ lesion. He was started on interferon-beta-1a s.c. in 2013. Read More
Click here to watch Dr. Virender Bhan discuss the case and the responses to the survey.
Joseph is a 28-year-old shipping manager at a local warehouse. He is married and has a three-year-old daughter. He presents in April 2021 following an episode of right sided vision loss, with minimal pain. Exam showed visual acuity 20/400, loss of colour vision and an afferent pupillary defect. The rest of his neuro exam is normal. Brain MRI revealed MS-like white-matter abnormalities with a moderate burden of disease and evidence of right optic neuritis (T2 hyperintensity and contrast enhancement). He was treated with IVMP 1000 mg daily x 3 days, with minimal improvement. There is no history of comorbid conditions and no family history of demyelinating or autoimmune disorders. He has not received a COVID-19 vaccine. Extensive discussion does not change his mind and he says he has no plans to get vaccinated. Read More
Click here to watch Dr. Courtney Casserly discuss the case and the responses to the survey.
Alison, 31, is a lawyer, married with no children. She was diagnosed with RRMS in 2014. Her initial presentation was vertigo, diplopia and mild ataxia. EDSS score was 2.0. She was started on glatiramer acetate but was switched to fingolimod in 2016 after experiencing two relapses. Read More
Click here to watch Dr. Daniel Selchen discuss the case and the responses to the survey.
Kay, 39 years old, is sales clerk at a downtown department store. In 2009, at age 27 years, she was diagnosed with RRMS. Her initial presentation was optic neuritis, but she subsequently developed brainstem symptoms, including mild vertigo and difficulty swallowing. There was no family history of demyelinating or autoimmune disorders. There was no significant medical history and no comorbidities. Read More
Click here to watch Dr. Virender Bhan discuss the case and the responses to the survey.
Elizabeth, 28, is referred by her family practitioner with a note that her MRI report is suggestive of MS. She is married with two children and is currently employed as a middle school teacher. She has a history of episodic migraine but is otherwise healthy. She reports no neurological symptoms. There is no history of recreational drug use. There is no family history of demyelinating diseases including MS. Elizabeth tells you she has a maternal aunt with fibromyalgia. Read More