| *H&P: Demyelinating autoimmune disease that can be relapsing remitting, primary or secondary progressive, or progressive/relapsing. | | *H&P: Demyelinating autoimmune disease that can be relapsing remitting, primary or secondary progressive, or progressive/relapsing. |
| *Dx: MRI shows periventricular fingerlike white matter lesions, LP shows oligoclonal bands, '''VEPs show delayed conduction''' | | *Dx: MRI shows periventricular fingerlike white matter lesions, LP shows oligoclonal bands, '''VEPs show delayed conduction''' |
− | *Tx: '''1st Copaxone, Glatiramer acetate, or interferon'''. '''2nd Dimethyl fumarate, natalizumab, teriflunomide'''. Acute exacerbations use high-dose steroids. Symptom targeted treatment: SSRIs for depression; PT, stretching, massage, '''baclofen''' for spasticity; amantadine for fatigue; Gabapentin for neuropathic pain; timed voiding, fluid restriction, or oxybutynin for urinary incontinence | + | *Tx: '''1st Copaxone, Glatiramer acetate, or interferon'''. '''2nd Dimethyl fumarate, natalizumab, teriflunomide'''. Acute exacerbations use high-dose steroids (IV or PO are equally effective, but PO is preferred in patients with '''optic neuritis'''). Symptom targeted treatment: SSRIs for depression; PT, stretching, massage, '''baclofen''' for spasticity; amantadine for fatigue; Gabapentin for neuropathic pain; timed voiding, fluid restriction, or oxybutynin for urinary incontinence |