Immune-mediated demyelination of CNS, dissemination in space and time (McDonald criteria).
Clinical features
- • Optic neuritis
- • Sensory disturbance, weakness
- • Lhermitte, Uhthoff phenomena
- • Bladder dysfunction, fatigue
Investigations
- • MRI brain + spine with contrast (periventricular, juxtacortical, infratentorial, spinal cord lesions)
- • CSF oligoclonal bands
- • Visual evoked potentials
Management
- • Acute relapse: methylprednisolone 1 g IV/PO × 3–5 d
- • Disease-modifying: interferon-β, glatiramer, dimethyl fumarate, teriflunomide; highly active disease: natalizumab, ocrelizumab, alemtuzumab
References
- • NICE CG186 MS 2014/2022
Related in WardRound
Educational — verify locally.
