• Recognize the risk factors for MS:
  • Age: typically younger (20-40 years old)
  • Female > Male (3:1)
  • Family History of MS
  • Infections (EBV)
  • Race – white, northern European decent
  • Smoking
  • Autoimmune disease
  • Northern hemispheres (potentially related to lack of sunlight / vitamin D deficiency)
• Remember the THREE TYPES OF MS:
  • Primary progressive (Green)
  • Relapsing/Remitting (Blue)
  • Secondary progressive (Red)

Lhermitte Sign: a shock-like sensation radiating down the spine or limbs induced by neck movements.

Uhthoff Phenomenon: worsening MS symptoms with increased body temperature.

• Diagnosis requires the evidence of CNS demylenation in BOTH SPACE AND TIME.
• Remember the common eye findings with MS:
  • Optic neuritis: occurs in 50% of MS patients and is the presenting symptom in 20-30%
  • MLF syndrome: inability to adduct the affected eye; opposite eye can experience nystagmus
  • Marcus Gunn Pupil (afferent pupillary defect): inability of the affected eye to constrict when light is shown
• Oligoclonal bands IgG on LP
• Treatment regimen:
  • Routine: physical activity, vitamin D/calcium, routine vaccinations, smoking cessation
  • Acute: high dose steroids (typically 1 g/day for 3-5 days)