Simultaneous Stroke and first presentation of

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Simultaneous Stroke and first presentation of Multiple Sclerosis Dr A OConnor, Dr P OBrien Medical Department, Naas General Hospital 21-IMRIM-30 Introduction Multiple sclerosis (MS), an autoimmune disease of the central nervous system

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Simultaneous Stroke and first presentation of Multiple Sclerosis Dr A O’Connor, Dr P O’Brien Medical Department, Naas General Hospital 21-IMRIM-30<br>
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Introduction Multiple sclerosis (MS), an autoimmune disease of the central nervous system (CNS)
Patients may experience a gradual loss of visual, motor and sensory functions. Standardized definitions for the clinical courses of MS include relapsing-remitting, secondary progressive, primary progressive, and progressive relapsing (1) (2)
It is one of the most common causes of neurological disabilities in young adults and is recognized to be a pathological consequence of immune-mediated inflammation, demyelination and subsequent axonal damage(3)
Inflammation in autoimmune diseases can damage the normal physiological function of the endothelium, accelerate the process of atherosclerosis, and increase the risks of cerebrovascular diseases, particularly ischemic stroke (4)<br>
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Case History A 39-year-old female presented with gradual onset persistent focal neurological symptoms, with a concurrent 10 day history of neck and interscapular back pain
Initial physical presentation involved evolving weakness, tingling and paraesthesia over the distal right upper limb, progressively spreading into the right lower limb over the course of the previous 48 hours, and then involving right foot drop
Increased tone was noted on the same side, she had hyper-reflexia, and had a right upgoing plantar. Power was 4+/5
Cerebellar examination was normal
After several days, these symptoms largely resolved on the ward
PMHx: Vitiligo
Working diagnosis was demyelination .
MRI Brain and C-spine requested<br>