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Multiple Sclerosis


Step 1: View clinicals

A 25 year old woman presents with blurred vision and pain with movements of her left eye for 2 days. Further questioning reveals that she experienced a brief episode of numbness in her left forearm around 6 months ago, which resolved spontaneously. Her medical history is otherwise unremarkable and she is not on any medications.

Step 2: Order all relevant investigations

MRI brain

T2 weighted imaging shows three lesions in the periventricular region of the cerebrum; the left optic nerve demonstrates gadolinium enhancement.

ANA test


Serum NMO-IgG


Ocular tonometry

Intraocular pressure: 14 mmHg (Normal: 10 to 20)

Step 3: Select appropriate management

IV Methylprednisolone
Interferon Beta
Optic Canal Decompression
Prescribe Eyeglasses

Score: ★★☆