Is this Multiple Sclerosis? (temporary topic)

[Tessy]

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Hi, everybody! So I was doing a case study for one of my classes and wanted to make sure I got it right.
A 35-year old female has had several episodes, each separated by several months, in which she experiences brief periods of physical weakness, clumsiness of her legs and hands, visual disturbances, and mood swings. Her weakness is most prominent in her lowere extremities. CT scans show evidence of multiple lesions in the white matter of hte brain and spinal cord. During her last episode, there were increasing neurological deficits due to an increasing number of disseminated lesions. Prednisone (60 mg/day for 5 to 7 days) was prescribed and helped her return to as normal and active life as possible.
So it she suffering from MS? Why was she prescibed only 60 mg and only for a week. I found info that MS patients usually get 200 mg.
Thank you, your input will be greatly appreciated.

 

[QuinnB]

It seems pretty similar to a dx of MS given the many lesions separated temporally and physically; weird that they don't go into more detail on eye findings (b/l INO is pathognomonic) or physical exam findings and instead jump to CT, but I guess many practicing neurologists would get a CT anyway

 

[Tessy]

Thanx for the answer

 

[ericdamiansean]

Steroids just shorten the relapses, it does not change overall prognosis, and they probably want to be aware of the side effects of steroids itself..you do not want to be immunocompromising someone with neurological deficits

 

[ericdamiansean]

If you own Harrison's, you'll see that it states that treatment for acute relapses is oral prednisone 60 mg qA.M x 4 and then 40 mg qA.M x 4

 

[deleted109597]

Steroids just shorten the relapses, it does not change overall prognosis, and they probably want to be aware of the side effects of steroids itself..you do not want to be immunocompromising someone with neurological deficits

What are you talking about. Steroids are f'ing awesome. For everything. (kidding)

 

[emtji]

a good uptodate search will help, but what i remember from last block....

i thought it was methylprednisone in the range of 200mg iv qday. i could be wrong of course.

 

[ericdamiansean]

What are you talking about. Steroids are f'ing awesome. For everything. (kidding)

Got my source from Harrisons..it's a f'ing awesome book😀

 

[VJWDO]

I can tell you from experience I was treated with 1000mg solumedrol IV for one week for my first severe episode. Haven't had one since because I was just diagnosed three years ago. I think that treatment varies among neurologists.

 

[VJWDO]

i meant 1000mg solumedrol IV daily times 1 week.