Case Studies in Multiple Sclerosis PDF
Preview Case Studies in Multiple Sclerosis
Paul S. Giacomini Editor Case Studies in Multiple Sclerosis Case Studies in Multiple Sclerosis Editor Paul S. Giacomini Case Studies in Multiple Sclerosis Editor Professor Paul S. Giacomini Montreal Neurological Hospital and Institute McGill University Health Centre McGill University Montreal, Quebec, Canada ISBN 978-3-319-31188-3 ISBN 978-3-319-31190-6 (eBook) DOI 10.1007/978-3-319-31190-6 © Springer International Publishing Switzerland 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprint- ing, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulati ons and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Adis imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland Project editor: Katrina Dorn Acknowledgements I am very grateful to my many colleagues who have generously contributed to this work by authoring cases, and in doing so, sharing their wisdom, knowledge and experience in the management of patients with multiple sclerosis. I am also grateful to Dr. Jack Antel and Dr. Liam Durcan of McGill University, my friends and mentors of many years, who first kindled my interest in neurology and continue to serve as role models to this day. This book is dedicated to my family, my wife Valerie and my two children, Katie and Jack, for their unwavering love and support over the years, and for putting up with both my presence and absence alike. I am eternally grateful for their devotion and patience that seem to know no bounds. Contents Author biography XIII Contributors XV Preface XVII CLINICALLY ISOLATED SYNDROME Case 1: Optic neuritis 3 History 3 Examination 3 Investigations 4 Outcome 4 Discussion 4 Clinical pearls 9 References 10 Case 2: Myelitis 11 History 11 Examination 11 Investigations 12 Outcome 13 Discussion 14 Clinical pearls 16 References 16 EARLY MULTIPLE SCLEROSIS Case 3: Disease-modifying therapies 19 History 19 Examination 19 Investigations 19 Outcome 20 Discussion 20 Clinical pearls 25 References 26 VII VIII CONTENTS Case 4: Management of relapses with corticosteroids 27 History 27 Examination 27 Investigations 28 Outcome 28 Discussion 28 Clinical pearls 31 References 31 ESTABLISHED RELAPSING-REMITTING MULTIPLE SCLEROSIS Case 5: Breakthrough disease 35 History 35 Examination 36 Investigations 36 Outcome 36 Discussion 37 Clinical pearls 41 References 42 Case 6: Progressive multifocal leukoencephalopathy 43 History 43 Examination 43 Investigations 44 Outcome 45 Discussion 45 Clinical pearls 48 References 49 Case 7: Induction therapy 51 History 51 Examination 52 Investigations 52 Outcome 53 Discussion 53 CONTENTS IX Clinical pearls 56 References 56 PRIMARY PROGRESSIVE MULTIPLE SCLEROSIS Case 8: Diagnosing primary progressive multiple sclerosis 61 History 61 Examination 62 Investigations 62 Outcome 64 Discussion 64 Clinical pearls 67 References 68 Case 9: Symptomatic care in primary progressive multiple sclerosis 69 History 69 Examination 69 Investigations 70 Outcome 70 Discussion 70 Clinical pearls 73 References 73 SECONDARY PROGRESSIVE MULTIPLE SCLEROSIS Case 10: Diagnosing secondary progressive multiple sclerosis 77 History 77 Examination 78 Investigations 78 Outcome 78 Discussion 78 Clinical pearls 82 References 82 X CONTENTS Case 11: Walking disability in multiple sclerosis 85 History 85 Examination 85 Outcome 86 Discussion 86 Clinical pearls 89 References 89 Case 12: Cognitive impairment 91 History 91 Examination 92 Outcome 92 Discussion 92 Clinical pearls 94 References 95 PEDIATRIC MULTIPLE SCLEROSIS AND RELATED DISORDERS Case 13: Acute disseminated encephalomyelitis 99 History 99 Examination 100 Investigations 100 Outcome 100 Discussion 100 Clinical pearls 105 References 106 Case 14: Pediatric multiple sclerosis 107 History 107 Examination 107 Investigations 107 Outcome 108 Discussion 108 Clinical pearls 111 References 112 CONTENTS XI Case 15: Pediatric multiple sclerosis mimics 113 History 113 Examination 113 Investigations 113 Outcome 113 Discussion 114 Clinical pearls 116 References 116 PREGNANCY AND MULTIPLE SCLEROSIS Case 16: Prenatal planning in multiple sclerosis 119 History 119 Examination 119 Investigations 120 Outcome 120 Discussion 120 Clinical pearls 122 References 123 Case 17: Multiple sclerosis therapies and pregnancy 125 History 125 Examination 126 Investigations 126 Outcome 126 Discussion 126 Clinical pearls 130 References 130 Case 18: Postpartum issues with multiple sclerosis 133 History 133 Outcome 133 Discussion 134 Clinical pearls 135 References 135
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