#
Answer:
Multiple sclerosis (MS).
#Definition:
Relapse remitting autoimmune central demyelinating process common among young females with high prevelance among people living in areas where sun exposure is less (vitamin D deficiency thought to play a role).
#Symptom_signs:
Optic neuritis : painful eye movement, monoccular vision loss, paradoxical pupilary response to light (instead of contracting they dilate),
weakness,
sensory symptoms,
bladder dysfunction and
paraplegia( Transverse mylitis).
Uhthoff sign: eye symptoms get worse with hot paths
Lehermitt sign: flexion of the neck induce severe pain that descend down on the back.
#Clinical_Pattern:
1- Relapse remitting (hit and run) 60-80%
2- primary progressive (getting worse with every attack)
3-secondary progressive : get worse after few remittance.
#Invx:
MRI /CSF oligoclonal IgG in 90%.
#Diagnosis:
Revised McDonald criteria 2017
#Treatment :
Supportive
Steroids, vitamin D.
#Reference :
Toronto notes 2020/neurology /page 799
