Case Study 3

A 30-year-old female was recently diagnosed with relapsing MS after presenting with weakness of the left leg and difficulty walking. A complete history taken at the time of presentation revealed that she had experienced several episodes of weakness and sensory disturbances over the previous 3 to 4 years for which she had not sought medical attention. MRI revealed numerous hyperintense T2 lesions in the brain and spinal cord, 2 of which were contrast-enhancing on T1-weighted images.

Medical history is notable for central obesity, hypertension, and dyslipidemia (ie, metabolic syndrome). The patient has a 12-year history of smoking, recently transitioning from half a pack per day of filtered cigarettes to electronic cigarettes. Medications include amlodipine and atorvastatin. A depression screen is negative.