Conversation: The conversation between human and AI assistant.
[|Human|] My 68 yr old male friend was diagnosed with Multiple Sclerosis 1 1/2 yrs ago. At the time he collapsed, was taken to the hospital and first diagnosed as having a stroke. Later it was diagnosed as MS. He has no use of his right arm and hand ( which is usually swollen) and drags his right leg and foot when walking. He is also a controlled diabetic. He is still not sure what he really has.
[|AI|]  Hello! I read the question and understand your concern. A multiple sclerosis is very exceptional to be diagnosed at this age. I don't know the MRI pattern, but a stroke in a diabetic patient may be misdiagnosed as multiple sclerosis in MRI because of lacuna strokes and periventricular post ischemic lesions. The difference may be done by a contrast enhancement which is consists with multiple sclerosis. The fact that the motor deficit is persistent is more consistent with stroke than multiple sclerosis. I would recommend a lumbar puncture with oligoclonal bands for diagnosis multiple sclerosis though not always it results positive. I would recommend him to keep taking aspirins and a stating as hypolipemiant to prevent a possible stroke. The best control of diabetes would be very helpful. Thank you for using Chat Doctor! Best wishes