An illustrated pocketbook of multiple sclerosis by Charles M. Poser

By Charles M. Poser

This illustrated pocketbook offers an simply obtainable precis of key matters when it comes to diagnosing a number of sclerosis and handling sufferers at diverse phases of the disease.

summary: This illustrated pocketbook offers an simply available precis of key concerns when it comes to diagnosing a number of sclerosis and coping with sufferers at diversified phases of the disorder

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High-power view of the same area (lower) shows alternating bands of normal myelin and remyelmation. Weigert stains. Shiraki, University of Tokyo, Japan 28 AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS Figure 20 Gross specimen of brain from a patient with Schilder’s myelinoclastic diffuse sclerosis shows large bilateral areas of demyelination Figure 21 Celloidin section of brain from a patient with Schilder’s myelinoclastic diffuse sclerosis shows a large plaque occupying most of the centrum semiovale.

This phenomenon is relatively uncommon 58 AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS Figure 38 Sagittal proton density MRI of the spinal cord shows a completely extruded disk compressing the cord at the level of T7–8. Note the areas of increased signal intensity extending both above and below the site of compression. There is also cord compression at the T9–10 level. The patient had suffered from a fall around 2 months previously AN ILLUSTRATED POCKETBOOK OF MULTIPLE SCLEROSIS 59 Figure 39 Axial (left) and sagittal (right) T2-weighted MRIs show severe spondylosis at C4–5 with cord compression.

Signs and symptoms may appear in some MS patients due to slowing of nerve conduction caused by a rise in body temperature as a result of either ambient heat or fever (Uhthoff’s phenomenon). The latter is a common cause of pseudoexacerbations. 1°C may be sufficient to cause such signs and symptoms, which disappear upon cooling. By far the most common cause of these pseudo-exacerbations is an unsuspected urinary tract infection. Clinical aspects Multiple sclerosis most frequently affects the optic nerve and chiasm, brain stem, cerebellum and the cervical spinal cord.

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