Multiple Sclerosis 



Pathologically, multiple sclerosis is associated with the present of plaque of inflammatory demyelination within the central nervous system. Multiple sclerosis may be relapsing remitting, primary progressive, secondary progressive and fulminant. 

Multiple sclerosis present with variable set of symptoms and signs and usually diagnosed by identifying two or more neurological symptoms which are separated by time and space. 

Patient may appear sitting in a wheelchair with contracture. The tone of the leg will increase with reduction of power and weakness . The reflex of the leg will be increased. Patient may present with cerebellar signs such as past pointing and intention tremor. Optic atropy, optic neuritis and internuclear ophthalmoplegia may also present. Visual evoked potential assessment is useful in confirming the diagnosis.

The common investigations of multiple sclerosis are MRI scan to demonstrate the present of the plaque and oligoclonal band detection from the analysis of the cerebrospinal fluid. 

High dose of steroid and beta interferon are useful in treating multiple sclerosis.

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