Teaching case: a man with a progressive gait impairment and visual compromise

Area of Science:

• Neurology
• Clinical Case Study

Background:

• Primary progressive multiple sclerosis (PPMS) presents with diverse neurological symptoms.
• Gait impairment significantly impacts patient quality of life in MS.

Observation:

• A 52-year-old male diagnosed with PPMS presented with visual disturbances and gait difficulties.
• Symptomatic treatment with dalfampridine yielded minimal improvement.

Findings:

• Dalfampridine, the first approved drug for MS gait symptoms, shows limited efficacy, with only 40% of patients responding objectively.
• PPMS remains a therapeutic challenge with no approved disease-modifying treatments.

Implications:

• This case underscores the need for novel therapeutic strategies for PPMS.
• Continued research into PPMS pathophysiology is crucial for developing effective disease-modifying treatments.
• Symptomatic management remains vital for improving the quality of life for PPMS patients.