Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Distinct episodes of neurologic deficit:
• Separated in time.
• Attributable to focal white matter lesions separated in space.
• Prevalence of about 1 per 1,000 in US and Europe.
• Most cases become evident in childhood or after 50 years of age, although the disease can be diagnosed at any age.
• Women 2 to 1 over men.
• Clinical course is marked by relapsing and remitting flare-ups, with a general steady neurological deterioration.
• Unilateral visual impairment is common.
• Brainstem involvement produces cranial nerve signs.
• Both sensory and motor involvement.
• Spasticity of limbs and trouble with voluntary bladder control.
• Symptoms often made worse by exposure to heat.