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Clinical presentation

• Signs and symptoms


Four categories have been used to Blindness
describe the course of the disease:
relapsing-remitting, primary progressive, Nystagmus and double vision
secondary progressive, and progressive-
relapsing.
incoordination, spasticity, difficulty
in walking, loss of balance and
vertigo, coordination or weakness,
First clinical signs of multiple sclerosis tremor or paralysis of a limb
- Begin in young adulthood.
- According to which region of the CNS is involved (motor or bowel and bladder incontinence
sensory region) and what degree of disruption occurs in the
myelin sheath

Imprecise speech or tremor

loss of touch, pain, temperature,


and proprioception

Fatigue and worsening fatigue in


the afternoon
• Laboratory findings
Made on the basis of information derived from the history, clinical examination, CSF,
sensory evoked potential, and magnetic resonance imaging (MRI) performed over
time.

 MRI scans typically reveal multiple


two or more clinical
hypodense demyelinated regions
attacks occur in a patient (plaques) in white matter, usually near
who has two or more the ventricles, brainstem cerebellum,
affected CNS locations
and optic nerves
Diagnose of
 The CSF shows signs of low-grade
MRI lesion newly appears
Relapsing – remitting after a second clinical inflammation
multiple sclerosis attack  Protein and immunoglobulin levels are
increased in 80% to 90% of patients
after one clinical attack
 Antibodies to myelin basic protein
when a new MRI lesion detected in the CSF
appears
 The conduction response to visual
stimuli or somatosensory evoked stimuli
is usually delayed and altered in
amplitude