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19 - Multiple Sclerosis

from SECTION III - SPECIFIC NEUROLOGICAL CONDITIONS

Published online by Cambridge University Press:  06 August 2009

Thomas F. Scott
Affiliation:
Department of Neurology Allegheny General Hospital Pittsburgh, Pennsylvania
Sid M. Shah
Affiliation:
Michigan State University
Kevin M. Kelly
Affiliation:
Drexel University, Philadelphia
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Summary

The primary pathological event in multiple sclerosis (MS) lesion development is an immune-mediated destruction of the neuronal myelin sheath. The inflammatory lesions of MS can affect any part of the central nervous system and optic nerves, resulting in a wide variety of presenting symptoms. The first symptoms of MS are commonly weakness, paresthesias, visual loss, incoordination, vertigo, and sphincter impairment. Focused testing of cranial nerve function, strength, coordination, gait, and sensation, and an evaluation for pathological reflexes are important. The onset of MS is heralded by a bout of optic neuritis in about 20% of patients with MS, and more than 50% of patients with optic neuritis eventually develop the disease. Neuroimaging assists in differentiating MS from mass lesions, infections, or strokes. Patients with relapsing-remitting multiple sclerosis (RRMS) who experience an acute exacerbation of their illness present with either recurrence or worsening of old symptoms, or entirely new neurological symptoms.
Type
Chapter
Information
Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
, pp. 210 - 217
Publisher: Cambridge University Press
Print publication year: 2003

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References

Matthews W B, ed. McAlpine's Multiple Sclerosis. New York, NY: Churchill Livingstone; 1991: 43–71
Poser, C, Presthus, J, Horstal, O. Clinical characteristics of autopsy-proved multiple sclerosis. Neurology. 1966; 16: 791Google Scholar
Poser, C M, Paty, D W, Scheinberg, L, et al. New diagnostic criteria for multiple sclerosis. Guidelines for research protocols. Ann Neurol. 1983; 13: 227–31Google Scholar
Schumacher, G A, Beebe, G, Kibler, R F, et al. Problems with experimental therapy in multiple sclerosis: report by the panel on evaluation of experimental trials of therapy in multiple sclerosis. Ann NY Acad Sci. 1965; 122: 552–68Google Scholar

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  • Multiple Sclerosis
    • By Thomas F. Scott, Department of Neurology Allegheny General Hospital Pittsburgh, Pennsylvania
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.020
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  • Multiple Sclerosis
    • By Thomas F. Scott, Department of Neurology Allegheny General Hospital Pittsburgh, Pennsylvania
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.020
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Multiple Sclerosis
    • By Thomas F. Scott, Department of Neurology Allegheny General Hospital Pittsburgh, Pennsylvania
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.020
Available formats
×