A 35-year-old woman was active in jogging and horseback riding until 1 year ago. During the past year she began to notice severe weakness and paresthesias in her legs. Her gait became unsteady, and she developed loss of vision in one eye. A neurologist suspected multiple sclerosis (MS) and ordered the following studies:
\nStudies Results
\nRoutine laboratory work Within normal limits (WNL)
\nLumbar puncture with cerebrospinal fluid (CSF) examination, p. 651
\nImmunoglobulin (Ig) G index 0.8 (normal: 0.3-0.7)
\nIgG determination 20% (normal: 0%-11% of total protein)
\nOligoclonal bands Present (normal: none)
\nEvoked potentials (EPs), p. 562
\nVisual-evoked potentials Abnormal latency
\nAuditory brainstem-evoked potentials Normal
\nSomatosensory-evoked responses Abnormal latency
\nMagnetic resonance imaging (MRI), p. 1106 Plaques indicative of multiple sclerosis
\nDiagnostic Analysis
\nThe wide variety of symptom manifestation often makes MS difficult to diagnose; however, the above studies clearly identified MS as the patient\u2019s problem. The CSF study results were classic for the diagnosis of MS. The abnormal latency demonstrated on the EP studies was the result of the demyelination process of MS. MRI revealed plaques indicative of MS.
\nThe patient was given prednisone to decrease the inflammation and associated edema of the myelin sheath. When remission occurred, she was instructed about factors that exacerbate, prevent, or ameliorate symptoms.
\nCritical Thinking Questions
\n1. Why were the results of the CSF study classic for the diagnosis of MS?
\n2. What is latency, and why is it increased in MS?<\/p>\n","protected":false},"excerpt":{"rendered":"
Multiple Sclerosis (MS) A 35-year-old woman was active in jogging and horseback riding until 1 year ago. During the past year she began to notice severe weakness and paresthesias in her legs. Her gait became unsteady, and she developed loss Read More …<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[],"class_list":["post-431316","post","type-post","status-publish","format-standard","hentry","category-essay-paper-writing"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/431316","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=431316"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/431316\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=431316"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=431316"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=431316"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}