Respiratory tract infections
A 32-year-old white female presents to Urgent Care with complaints of blurry vision and “fuzzy thinking” which has been present for the last several weeks. She works as an executive for an insurance company and puts her symptoms down to the stress of preparing the quarterly report.
Today, she noticed that her symptoms were worse and were accompanied by some fine tremors in her hands. She has been having difficulty concentrating and has difficulty voiding. She remembers her eyes were bothering her a few months ago and she went to the optometrist, who recommended reading glasses with a small prism to correct double vision. She admits to some weaknesses as well.
No other complaints of fevers, chills, upper respiratory tract infections, or urinary tract infections. Past medical and social history is non-contributory. The physical exam is significant for the 4th cranial nerve palsy. The fundoscopic exam reveals oedema of the right optic nerve causing optic neuritis. Positive nystagmus on positional maneuvers.
There are left visual field deficits. There was short-term memory loss with the listing of familiar objects. The APRN tells the patient that she will be referred to a neurologist due to the high index of suspicion for multiple sclerosis (MS).
Question:
What is multiple sclerosis and how did it cause the above patient’s symptoms?
