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