- chronic demyelinating condition - incidence related to latitude; tasmania among areas with highest incidence in the world common relapse patterns include: - ataxia - proximal weakness (lower limbs > upper limbs) - urinary symptoms - cranial nerve disorders - optic neuritis - diplopia - vertigo - fatigue - heat sensitivity (symptoms are worse in the summer) **optic neuritis:** sudden loss of vision (partial or complete), sudden blurred or foggy vision, pain on movement of the affected eye. - disturbed or blackened, rather than blurry, indicate moderate stage and require immediate medical attention to prevent further loss of vision - reduced night vision, photophobia, red eyes - loss of colour vision in affected eye, especially red , and otherwise washed out **internuclear ophthalmoplegia** - disorder of conjugate lateral gaze in which the affected eye shows impairment of adduction. when an attempt is made to gaze contralaterally relative to affected eye, the affected eye adducts minimally, if at all. the contralateral eye abducts, however with nystagmus ![[Pasted image 20240307185411.png]] # Ix - MRI with white matter lesions or homogeneous periventricular lesions on T2-weighted MRI of brain / spinal cord - CSF - elevated protein and gammaglobulins (oligocloncal bands) and pleuocytosis with mild lymphocytosis # Tx - pulse therapy with methylprednisolone 1g IV daily for 3 days or equivalent oral dose - Vitamin D - long term DMARDs