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Study Questions

Multiple Sclerosis Guidelines: AAN's Recommendations for Initiating, Switching, Stopping Disease-Modifying Therapy

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Content 13

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Question 1

A 25-year-old woman presents to the hospital because of blindness in her right eye. She has a twin sister with a similar condition. Many years ago, her sister went blind in one eye, but the blindness resolved and she has never had any other neurologic symptoms. The physician obtains cerebrospinal fluid and submits it for laboratory testing. The laboratory testing reveals oligoclonal bands. What should the physician tell the patient regarding her condition?

The blindness is most likely not caused by the same condition that your sister had, so we need to test you for antinuclear antibodies

This may be your only episode of neurologic dysfunction, but most likely you will have other episodes in the future, not necessarily involving the eyes

Like your sister, this will be the only episode you have like this

Unlike your sister, you will probably have multiple neurologic episodes and end up wheelchair bound

The correct answer is B.

Explanation:

The patient most likely has multiple sclerosis (MS). In most cases, MS has a waxing and waning course, but the clinical history can vary from patients having one episode with no subsequent episodes to patients having multiple episodes one after the other, leaving them wheelchair bound or worse. Patients often present with visual symptoms.

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