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.
She has been clinically stable since 2016. Her EDSS score is unchanged. Her last MRI eight months ago revealed three new lesions, one enhancing, but she was happy on therapy and did not want to make a switch at that time.
The patient tells you she wants to get pregnant in the next 6-12 months.