The clinical therapeutic trials are all aimed at altering the patients' immune system, inasmuch as the demyelination in MS is thought to be immune mediated. The results of treatment of chronic progressive MS, whether slow or rapid in its course, is dismal. We consider azathioprine, cyclophosphamide, cyclosporine, lymphatic irradiation and plasmapheresis as experimental treatment modalities without important therapeutic effect. Case studies A 36 year-old laborer, bom and raised in Brazil, has been living in Southern Louisiana for the past two years working as a fisherman. Over the past several months he has been developing a gradually progressive weakness and numbness of both lower extremities, problems with balance and coordination, and urinary retention.
Cranial nerves are normal.
Discuss a comprehensive differential diagnosis. Select three diagnostic tests, which would most likely narrow down your differential diagnosis. A 57 year-old Caucasian female house wife, obese, known hypertensive, and insulin dependent diabetic for the past 15 years, has developed weakness and numbness in the lower extremities over the past several months. The primary care physician has obtained a MRI of the brain without Gadolinium contrast. The primary care physician, during a casual conversation in the cafeteria, requests your opinion on the case without giving you any details on the neurologic examination and wants to know which other diagnosis tests you would request.