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Diagnosis of Multiple Sclerosis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Multiple Sclerosis
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   if a patient has sulcus perivascular ischemic changes and mild atrophy, is the diagnosis MS or are there other differentials? In addition, his proximal left carotid artery is 95% stenosed, too. patient has high cholesterol, etc. Had an acute blindness episode. Blurred vision. numbness in hands.
Doctor :   Hi
User :   hi
Doctor :   The diagnosis of Multiple Sclerosis is based on clinical findings, radio diagnostic features.
Doctor :   Perivasular ischemic changes alone are not diagnostic of multiple sclerosis.
User :   k, MRI showed no lumbar lesions either
User :   what other differentials....he's clumsy, etc.
Doctor :   May I know the patients age and gender?
User :   acute attack of slurred speech which resolved
Doctor :   Since when are these symptoms seen?
User :   male, 76,
User :   symptoms of blindess and slurred speech about a month agao
User :   both resolved
Doctor :   Ok
Doctor :   Did he have similar symptoms in the past?
User :   dizzy yes, BTW meds: Capozide, Mevacor, Ticlid, and Voltaren, but I don't know the exact amounts."
Doctor :   Ok
User :   car accident when a child, suffered some major head injuries,
Doctor :   Ok
Doctor :   Let me brief you.
Doctor :   An acute episode of slurred speech with vision problems are features of stroke(vascular injury) or a demyelination.
User : stroke, too?
User :   ohhh, demyelination separate differential
Doctor :   Demyelination is not stroke.
The progression the symptoms, aided by the MRI and CSF analysis is useful in differentiating these conditions.
User :   CSF is normal
Doctor :   There are different forms of demyelination, and when they occur recurrently, involving different areas of the brain, it is referred to as MS>
User :   The MRI results show ischemia and atrophy. is that demyelination?
Doctor :   If the MRI and CSF analysis were not diagnostic of demyelination, then it may be a vascular injury
Doctor :   that has caused the symptom.
User :   k
User :   a TIA?
Doctor :   TIA is one a mild form of stroke.
Doctor :   A mild form of vascular injury.
Doctor :   You need to discuss with the doctor who had examined him,
Doctor :   It seems you have moved out of the chat window. Please log in back if you have medical queries
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