Multiple sclerosis
Posted by dkwinter

Hx
     Multiple symptoms in space in time
Sx
     Weakness     
     Tingling
     Eye pain
     Vision changes
     Internuclear ophthalmoplegia
     Paresthesias
     Sensation of electrical shocks down the spine (Lhermitte's sign)
Workup
     CBC, ESR
     VDRL/RPR
     MRI-brain
     LP-CSF analysis
     Retinal evoked potentials
Labs
     CSF
          Pressure is grossly normal
          Protein is grossly normal
          Cell count is grossly normal
               T-lymphocytes are the predominant cells
          Oligoblonal bands/High levels of immunoglobulins (predominantly IgG, although IgM and IgA are also increased)--NOT diagnostic since may be seen in other diseases such as neuropathies, chronic central nervous system infections or viral syndromes