What is Lynn’s likely diagnosis? Which of the findings of the medical tests support this diagnosis?
Lynn is a 38 y.o. mother of two, a 10 y.o. girl and a 2 y.o. boy. She is active and has always enjoyed good health. For the past two weeks, Lynn has been having problems with her right lower extremity during her daily walks. She has noticed that she is tending to catch her toe more, especially toward the end of the walk. It is also harder for her to go upstairs. A physical therapist friend does a manual muscle test on her lower extremities and finds that the left lower extremity tests normal at 5/5, but that the hip and knee muscles of Lynn’s right lower extremity only test at 3/5. The physical therapist recommends Lynn see a neurologist, which she does.
The neurologist performs several diagnostic tests and does two MRIs over the next few weeks. The findings of the tests include the following.
MRI: Evidence of 4-5 plaques in the spinal cord.
Visual Evoked Potential (VEP): Slowed response time.
Blood Tests: Normal.
Cerebral Fluid Analysis: Oligoclonal bands present.
Elevated IgG antibodies.
After approximately 1 month and several other tests, Lynn is given a diagnosis. She is told to expect exacerbations and remissions. Lynn is given glucocorticoids to take during exacerbations.
- a) What is Lynn’s likely diagnosis? Which of the findings of the medical tests support this diagnosis? Which of the findings is the most conclusive for this disease?
- b) What causes this disease? What happens to the nerves in this disease? Are there cognitive deficits?
- c) Does it affect men or women more often? Is it common?
- d) Why is Lynn given glucocorticoids to take during exacerbations, what will they do for her?
- e) How will this disease progress over the next few years? What is the prognosis?
