By Charles M. Poser
This illustrated pocketbook provides an simply obtainable precis of key concerns in relation to diagnosing a number of sclerosis and handling sufferers at assorted levels of the disease.
summary: This illustrated pocketbook offers an simply obtainable precis of key matters when it comes to diagnosing a number of sclerosis and coping with sufferers at assorted phases of the affliction
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Additional info for An illustrated pocketbook of multiple sclerosis
Burned-out’ cases are rarely mentioned, yet constitute approximately 20% of cases. In such a case, the disease seems to have become arrested. Most of these patients have become wheelchair-bound, but their upper extremities remain functional. MS can also follow a hyperacute course, leading to death in a matter of a few weeks; this type has been called ‘Marburg disease’. 36 AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS Many of those cases are actually cases of acute monophasic disseminated encephalomyelitis rather than MS.
The nosological situation of what is often designated as a variant of MS—Devic’s disease or neuromyelitis optica—is the subject of dispute. Lesions affect only the optic nerves and spinal cord, not necessarily simultaneously. It is estimated that only approximately one-quarter of cases of neuromyelitis optica are cases of MS; the rest are most probably instances of postinfectious encephalomyelitis. Electron microscopy of the classical lesion of MS reveals a number of characteristic changes (Figure 22).
The patient had suffered from a fall around 2 months previously AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 59 Figure 39 Axial (left) and sagittal (right) T2-weighted MRIs show severe spondylosis at C4–5 with cord compression. Note the areas of increased signal intensity immedi-ately below the compression site (arrow; right). Spondylosis at C5–6 has obliterated the subarachnoid space anteriorly. The cord is shoved backwards, causing narrowing of the subarachnoid space posteriorly from C3–4 downwards.
An illustrated pocketbook of multiple sclerosis by Charles M. Poser