Multiple Sclerosis – Challenges in Diagnosis
DOI:
https://doi.org/10.33102/mjosht.v8i.271Keywords:
multiple sclerosis, numbness, challenge, diagnosis, non-specificAbstract
Multiple Sclerosis is an inflammatory demyelinating disease that affects the central nervous system, and is uncommon among the Asian population. It can present with a variety of symptoms, depending on the location of the demyelinating plaques, which could also potentially mimic a range of neurological and non-neurological disorders. We report a 24-year-old woman who presented with recurrent non-specific lower limb numbness, without any other neurological symptoms or signs. The symptoms were presumed to be nonspecific, but they re-occurred eight months later, leading to a more extensive investigation, including whole spine and brain MRI. The MRI showed multiple white matter lesions that are hyperintense on T2W/FLAIR, seen at the right corona radiata, bilateral parietal lobes, right periventricular region and spinal cord, with a simultaneous presence of gadolinium-enhancing and nonenhancing lesions, fulfilling 2017 Mc Donald’s diagnostic criteria for multiple sclerosis. After the careful exclusion of differential diagnoses, she was given pulsed IV methylprednisolone for 5 days, followed by oral teriflunomide. She improved partially, and at 2 months following discharge, she was tolerating the medication well with no further relapses.
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Copyright (c) 2022 Nur Ezzaty Mohammad Kazmin, Hui Jan Tan, Hana Maizuliana Solehan, Fatimah Zanirah, Wei Ming Tan, M Firdaus A Bakar, Sarah Zulaikha Samad
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