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ccs case for woman with multiple sclerosis - angelwood
#1
present with weakness & Nystagmus on neurological exam.

Please pose management for this case.
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#2
aspirin and steroids ASAP.

than will do work up.
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#3

Pt presents with acute neurologic deficit and a Hx unrelated neurologic deficits

ABC i case if its a life threatening defeicit
cbc
bmp
ua
s lipid pro
ekg
s vitamin b12
vdrl/rpr
elisa for hiv if multiple sex partner
MRI
consult neurologist
lumbar puncture
CSF protein/ IgG
Fundus Exam

Confirmation with Hx, MRI and LP
Hospitalize
Methylprednisone for acute attack
Baclofen- Muscle rigidity
Amantadine- Fatigue
Docusate- Constipation
SPasticity- Dantrolene
Symptomatic Treatment
interferon/glatiramer acitate

Neurology Consult
Neurorehabilitation
Reassurance
Occupatinal therapy
Ophthalmology Consult
Speech Therapy
Rehabilitation
adder hyperactivity oxybutinin
fatigue amantadine or flouxetine
bladder retention bethanecol
Contracpetive
Urodynamic studies
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#4
thank
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#5
Thanks for that nimish. Excellent.
Just wanted to add one more point..If a female pt, then perform Beta HCG before starting treatment with Glatiramer/IFN to rule out pragnancy..

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#6
yeah correct, and put pt on OCPs
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#7
some recommend starting pts on antidep prophylavtically due to inc depression with interferon.
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