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Multiple sclerosis relapse — RCPSC IM MCQ

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HardNeurologyMultiple sclerosis relapseRCPSC IM

A 29-year-old has optic neuritis and a prior sensory episode. MRI shows old and enhancing periventricular lesions typical of demyelination. What is the best next step?

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Correct answer: D — Refer for MS confirmation and disease-modifying therapy

The best answer is “Refer for MS confirmation and disease-modifying therapy”. Clinical attacks separated in time plus typical MRI lesions support multiple sclerosis after mimics are assessed. Specialist confirmation and early disease-modifying discussion are appropriate; vascular and vasculitic tests do not fit the syndrome, and indefinite steroids are not disease-modifying therapy.

Reference: Canadian Stroke Best Practices, acute ischemic stroke treatment: https://www.strokebestpractices.ca/recommendations/acute-stroke-management/acute-ischemic-stroke-treatment