A 34-year-old woman comes to the office due to diplopia, clumsiness of the left hand. Six months ago, the patient had numbness of the right hand, which resolved without treatment. The patient started having blurry vision and pain with eye movement 2 days ago. She has no other medical problems and takes no medications. The patient has a 10-pack-year smoking history. Both parents are healthy. Vital signs are normal. BMI is 27 kg/m². Neurologic examination shows slowing of left eye adduction and left arm power of 4/5 with mild spasticity. Sensation to pinprick is decreased over the right foot. This patient's diplopia is most likely caused by which of the following mechanisms?

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Quizplus · Accepted Answer

Eductional Objective: Multiple sclerosis is an autoimmune disorder of the central nervous system characterized by recurrent episodes of demyelination, leading to reduced saltatory conduction.  Internuclear ophthalmoplegia and optic neuritis are common manifestations.

A 34-Year-Old Woman Comes to the Office Due to Diplopia