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Multiple Sclerosis: An Emergency Medicine-Focused Narrative Review.
Jessica Pelletier1, Davis Sugar2, Alex Koyfman3
1Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri.
The Journal of Emergency Medicine
|March 12, 2024
Summary
Multiple sclerosis (MS) is a rare autoimmune disorder affecting the central nervous system. Early diagnosis and management of MS flares in the emergency department are crucial to reduce patient morbidity.
Area of Science:
- Neurology
- Immunology
Background:
- Multiple sclerosis (MS) is a rare but serious autoimmune disorder impacting the central nervous system (CNS).
- It is characterized by relapses and lesions disseminated in time and location, leading to significant morbidity.
Approach:
- This review focuses on the presentation, evaluation, and emergency department (ED) management of MS for emergency clinicians.
- It emphasizes current evidence-based practices for diagnosing and treating MS flares and clinically isolated syndromes (CIS).
Key Points:
- Common MS presentations include long tract signs, optic neuritis, and brainstem syndromes.
- Management of acute MS flares and CIS in the ED involves corticosteroid therapy, imaging, and cerebrospinal fluid analysis.
- Failure to diagnose MS or its flares promptly increases patient morbidity.
Conclusions:
- Understanding MS presentation and management is vital for emergency clinicians.
- Appropriate diagnosis and management of MS in the ED can improve patient outcomes and reduce long-term disability.
