Advances in Multiple Sclerosis Case Management

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These activities are supported by an educational grant from Bayer HealthCare Pharmaceuticals, Inc.

INTRODUCTION

Multiple sclerosis (MS) is a neurological disease believed to be the result of a complex combination of environmental, genetic, and autoimmune factors. Inflammation, destruction, and scarring of cells that protect the neurons in the central nervous system characterize its pathology. MS is approximately twice as common in women as in men and a significant cause of morbidity and mortality among young people. The typical age at onset is 20-40 years. Recent data suggest that its prevalence among women is increasing.

MS treatments were not developed until the late 1900s. The ultimate therapeutic goal remains lack of relapse and disease progression, but this ideal is rarely achieved. Recent studies suggest that the onset of MS can be delayed by early initiation of immunomodulatory therapy and that efficacy may be enhanced through increased doses at more frequent intervals. Improvements in magnetic resonance imagery have also contributed to better monitoring and accurate diagnosing of MS.

The management of patients with MS requires understanding an evolving therapeutic paradigm in which the mechanisms, efficacies, and effects of available therapies are of great importance. This CME series provides the knowledge and instruction necessary to achieve this understanding, and to apply the latest academic and clinical insights in MS case management to everyday practice. Each course provides a maximum of 0.5 AMA PRA Category 1 Credit™.

Please note that the courses are accredited only for physicians (MD, DO, or equivalent). All other participants receive a certificate of completion.

AVAILABLE COURSES

A 35-Year-Old Man With Lower Limb Weakness

DESCRIPTION
John J—, a 35-year-old African American man presents with numbness in his lower extremities and torso. John developed bilateral numbness and paresthesia in the soles of his feet 3 days ago. He initially attributed the paresthesia to a pinched nerve; however, he became increasingly worried over the next few days when the numbness steadily spread to involve his legs and upper torso.

A 28-Year-Old Postpartum Woman With Increasing Lower Limb Weakness

DESCRIPTION
Ruth P—, a 28-year-old African American woman treated with intramuscular (IM) interferon beta-1a (AVONEX) for multiple sclerosis (MS), presents with increasing weakness in her lower extremities. Ruth has a 5-year history consistent with relapsing-remitting MS. She discontinued treatment during pregnancy with her second child and postponed treatment so she could safely breastfeed. At 4 months postpartum, Ruth developed numbness and eventually weakness originating in her left leg that later spread to her right leg, and numbness of her torso to the level of her navel.

A 26-Year-Old Woman With Neurological Symptoms

DESCRIPTION
Linda M—, a 26-year-old white woman, presents with double vision, limb weakness, unsteady gait, fatigue, and difficulty concentrating. She began seeing double about 5 days ago, at which time she noticed having unsteadiness when walking and difficulty holding and gripping light objects (eg, her coffee cup). She also reports feeling more fatigued than usual and—although she ascribes it to worry over her symptoms—believes she is having difficulty focusing at work.

An Athletic 26-Year-Old Man With Leg and Vision Problems

DESCRIPTION
Frank B—, a 26-year-old white man, first visited his primary care physician (PCP) because of transient, unexplained orthopedic anomalies; ie, his left leg was intermittently “locking up.” Within months of initial presentation, Frank began to experience a loss of feeling in both legs, tingling in his right hand, and vision problems.