By Charles M. Poser

This illustrated pocketbook offers an simply available precis of key concerns on the subject of diagnosing a number of sclerosis and coping with sufferers at varied levels of the disease.

summary: This illustrated pocketbook offers an simply obtainable precis of key matters in terms of diagnosing a number of sclerosis and coping with sufferers at diverse levels of the sickness

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Extra resources for An illustrated pocketbook of multiple sclerosis

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Plaques of the spinal cord are rarely seen by CT AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 53 contrast medium and delaying imaging for one or two hours have greatly enhanced the ability of CT to reveal MS lesions, even in the spinal cord (Figures 33–35). Magnetic resonance imaging The introduction of magnetic resonance imaging (MRI) has completely revolutionized the diagnostic process of MS, but has proved to be a mixed blessing. The proliferation of MRI machines has led to their overuse and to misinterpretation of the images.

2001) AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 41 opinion, anMRIor a lumbar puncture is not necessary tomake the diagnosis ofMS. Examination of cerebrospinal fluid Lumbar puncture as an adjunct for the diagnosis of MS has become increasingly rare, but remains an essential procedure when other conditions, such as Lyme disease, sarcoidosis, HTLV-Iassociated paraparesis, AIDS, and neurosyphilis, must be ruled out. Thus, it remains a useful confirmatory test for MS. In an acute attack of MS, there is often a slight elevation of lympho cytes and of total protein.

Approximately 5–15% of clinically definite MS patients have completely normal MRIs on repeated examination. Conversely, there are patients with insignificant complaints who have MRI abnormalities that are similar to those frequently seen in symptomatic MS patients (Figures 37–39). The correlation between the number, site and size of MRI white matter AISIs and the clinical signs and symptoms of MS is very poor and unreliable. The often-used term ‘burden of disease’, based on the number and size of ‘lesions’, is misleading, as very large AISIs may be seen which have persisted for years in clinically normal subjects.

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