Case 13
Clinical History:
A 26 year-old female presented initially in February 1986 with transient right neck and shoulder numbness. Subsequently she developed optic neuritis. She was diagnosed to have multiple sclerosis clinically without confirmatory lab data (i.e., normal CSF and blood work). She continued to have exacerbations and remissions of neurologic symptoms in other parts of her body. She was treated with high dose steroids, which was subsequently changed to combination therapy with cyclophosphamide and prednisone due to progressive neurologic deterioration as well as increased frequency of attacks. In September 1987, the patient twisted her right hip and experienced severe pain despite normal radiographs and was treated with anti-inflammatory medication. No relief was evident.
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J. Anthony Parker, MD PhD, jap@nucmed.bih.harvard.edu
