An Unusual Presentation of Multiple Sclerosis in a Middle-Aged Woman: A Case Report and Literature Review

Curēus
Saurabh KatariaSaba Asif

Abstract

An intense itching localized to dermatomes is a rare symptom of multiple sclerosis (MS). Herein, we report a case of a 45-year-old female who presented with severe itching and tingling sensation, gait disturbance, and bilateral paresthesia for one week. She also had a history of multiple admission in the hospital due to recurrent walking abnormalities and numbness and tingling of both hands associated with intermittent psychiatric symptoms. The neurological examination revealed spastic quadriparesis with lower limb muscles affected more than the upper limbs, numbness, and sensory loss in the upper extremities in the glove and stocking pattern. Magnetic resonance imaging (MRI) revealed multiple small rounded periventricular plaques in both hemispheres and along the long axis of the corpus callosum (fluid-attenuated inversion recovery/FLAIR sequence), and cerebrospinal fluid analysis revealed the presence of oligoclonal bands, suggestive of MS. She was commenced on methylprednisolone and carbamazepine, leading to progressive resolution of her signs and symptoms. She was discharged with monthly natalizumab, and she was doing well on her follow-up.

References

Jan 1, 1979·Folia Psychiatrica Et Neurologica Japonica·S Yabuki, T Hayabara
Nov 1, 1976·The British Journal of Dermatology·P O Osterman
Jun 1, 1975·Brain : a Journal of Neurology·P O Ostermann, C E Westerberg
Jan 1, 1981·Journal of Neurology, Neurosurgery, and Psychiatry·M YamamotoS Otsuki
Mar 1, 1994·The International Journal of Neuroscience·R Sandyk
Nov 1, 1993·The British Journal of Dermatology·M C KoeppelJ Sayag

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