Female presents with history of difficulty walking
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Krupa Pandey, MD, Director, Multiple Sclerosis Center, Department of Neurology & Neuroscience Institute, Hackensack University Medical Center; Neurologist, Department of Neurology, Hackensack Meridian Health, Hackensack, NJ

Krupa Pandey, MD, has serve(d) as a speaker or a member of a speakers bureau for: Bristol-Myers Squibb; Biogen; Alexion; Genentech; Sanofi-Genzyme

Question 1 of 3

A 50-year-old woman presents with a history of difficulty walking that has gradually worsened over the past 3 years. She finds this alarming as she was very active in her 40s. A brain MRI is normal, but a cervical and thoracic MRI demonstrate multiple lesions without any gadolinium enhancement. The patient also presents with mild cognitive impairment and numbness in her left hand, as well as weakness of the left upper extremity and mild numbness of the face. For about a year, she has felt what she describes as a "clumsiness" when using her hands. The patient reports no significant medical history, with no previous neurologic problems, preceding infection, vaccination, fever, or rash.

What is the likely diagnosis?

Clinically isolated syndrome

Lyme disease

Relapsing-remitting multiple sclerosis

Primary progressive multiple sclerosis

Acute disseminated encephalomyelitis

This quiz is not accredited for CME.

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