The first magnetic resonance image of multiple sclerosis in Thailand.

ABSTRACT

The authors reported a 36 year old nurse with the symptoms of diplopia and fight hemiparesis for six days. She had been suffering from numbness on and off over the right side of the body for eight years for which was prescribed anxiolytic drugs. Examination revealed normal fundi, left lateral rectus paresis and horizontal phasic nystagmus. Mild right hemiparesis with exaggerated reflexes and fight Babinski sign were noted. Clumsiness of fight arm and fight leg were recorded as well as fight hemihypalgesia. Various investigations were performed. AII studies were within normal range, including blood chemistry profile, VDRL, ESR. LE, ANF, and anti-DNA. CT-scan showed normal result as well as lumbar puncture and transcranial Doppler ultrasonography. Evoked responses showed abnormal brainstem and somatosensory response, while the visual response was normal. Magnetic resonance image (MRI) was done and revealed multiple plaques over the left pons and periventricular region in both T1 and T2 weighted image. Prednisolone 60 mg/d was prescribed and she recovered satisfactorily. Within ten days, she was discharged home without any weakness. The numbness was diminished as ewll as her double vision. This is the first demonstration in Thailand using the expensive, noninvasive, sensitive and accurate MRI on MS. Investigating neurological patients using MRI still needs to be considered for cost-benefit.