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Multiple Sclerosis: Diagnose and Treatment

by Carlo Raj, MD
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    How are we going to diagnose it? How are you going to diagnose it? CSF, mildly elevated protein, gamma globulin is increased, and most importantly, oligoclonal bands. What does oligo mean? Little. So here, I want you to think of your clonal bands or the bands, in general. And as you’re interpreting a band, you have these little bands called oligoclonal bands, and those are quite indicative of multiple sclerosis if found by investigating your cerebrospinal fluid. Visual evoked potentials. Remember, you do have vision issues. Useful in demonstrating evidence of prior optic neuritis, but keep in mind though, frequently, the visual evoked potentials are found and there’s no history of the visual loss. Just keep that in mind as well. So you could have such abnormalities taking place but there is no history of optic neuritis. So these are things that you want to put everything together. Obviously, they’re not just going to give you one fact and expect you to know what’s going on. They’ll give you multiple clues and then you have to make sure that you use your clinical judgment to come to the proper diagnosis. What about treatment and such? If it’s acute relapse, you’re thinking about high dose IV corticosteroids. And then you have disease modifying agents. These include your beta interferons, beta interferons, beta interferons. I repeat that multiple times here because you don’t want to confuse this with alpha interferons or gamma interferons. These are beta. Then you have something called glatiramer acetate, and you have one of the monoclonal antibodies, natalizumab, is something that you want to keep in mind. In the parenthesis here are the trade names, but more importantly, you want to know about the generic names, obviously. In refractory cases, you’re not really left with much of an...

    About the Lecture

    The lecture Multiple Sclerosis: Diagnose and Treatment by Carlo Raj, MD is from the course Multiple Sclerosis. It contains the following chapters:

    • Multiple Sclerosis: Diagnose and Treatment
    • Multiple Sclerosis: Summary
    • Multiple Sclerosis: Variants

    Included Quiz Questions

    1. Gamma globulin
    2. Alpha globulin
    3. Beta globulin
    4. Zeta globulin
    5. Delta globulin
    1. Oligoclonal bands
    2. Lymphocytic pleocytosis
    3. Increased cell count
    4. Decreased glucose
    5. Increased opening pressure
    1. Visual evoked potentials
    2. CSF analysis
    3. Consensual and direct light reflex
    4. Indirect ophthalmoscopy
    5. CT scan
    1. High-dose corticosteroids
    2. Glatiramer acetate
    3. Beta interferon
    4. Natalizumab
    5. Immunosuppressant
    1. Bilateral optic neuritis
    2. Unilateral optic neuritis
    3. Intranuclear ophthalmoplegia
    4. Retrobulbar neuritis
    5. Peripheral neuropathy
    1. Patient presents with bilateral optic neuritis.
    2. It usually has a fulminant course.
    3. The presence of large numerous plaques.
    4. There is a widespread myelin destruction with axonal loss.
    5. It usually affects the young.

    Author of lecture Multiple Sclerosis: Diagnose and Treatment

     Carlo Raj, MD

    Carlo Raj, MD


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    By Hamed S. on 18. March 2017 for Multiple Sclerosis: Diagnose and Treatment

    Good summary of the topic but would have been also good further discuss some of the immunosuppresive agents and fingolimod. In the dx workup section the use of MRI was also omitted