Jennifer,* 40 Years

IDENTIFYING PATIENT TRANSITIONS IN MULTIPLE SCLEROSIS

**Jennifer,* 40 Years**

Diagnosed with RRMS in 2002

A stay-at-home mom with 2 children, she has had multiple relapses in the past year. Jennifer has switched DMTs twice in the past 5 years.

What is Jennifer's current Diagnosis?

Patient Notes*

Expanded Disability Status Scale (EDSS)²

Sustained progression of disease is predicted by a minimum score of 4,³ and an increase in EDSS score of at least one point (for scores ≤5.5), measured over two time points, at least three months apart.⁴

Patient Notes*

Relapses

Four relapses in the past year
Unresolved symptoms since most recent relapse:
- Double vision
- Balance issues
- Problems picking things up (fine motor skills)
- Leg pain
- Increasing fatigue

Current Symptoms

Double vision
Balance issues
Numbness and tingling in the fingers
Leg pain
Increasing fatigue
Difficulty with processing information

Functioning

Symptoms have impacted Jennifer's ability to care
for her children and other daily activities

As a physical sensation it reminds me of falling into quicksand/a swamp - it's a viscous, heavy, pulling feeling, but if I try to fight it, it hurts like hell and robs me of breath. As a sound, it's like a muted background noise of violins, scratching away, that seem to be ever increasing in speed and out of sync - while the outside world seems dampened and fading.12**

**Actual patient testimonial.

Patient History*

Clinical data⁶ from 6 months ago

Evoked potentials

Abnormal (prolonged) upper limb somatosensory evoked potentials (SSEPs)

Symbol Digit Modalities Test¹³

54.7

Modified Fatigue Impact Scale^9,10

44

Total Score

Brain MRI

Several demyelinated lesions

Permission granted by Springer International Publishing¹¹

Spinal MRI

Two cervical lesions

Permission granted by Springer International Publishing¹¹

Current Test Results*

Current results

Evoked potentials

Abnormal (prolonged) lower limb somatosensory evoked potentials (SSEPs)

Symbol Digit Modalities Test13

50.7

Modified Fatigue Impact Scale^9,10

44

Total Score

Brain MRI

Lesions have expanded in size and several new lesions are visible

Permission granted by Springer International Publishing¹¹

Spinal MRI

Same multiple cervical T2 lesion; no new lesion present

Permission granted by Springer International Publishing¹¹

*Not a real patient.

DMT, disease modifying therapy; EDSS, Expanded Disability Status Scale; MRI, magnetic resonance imaging; RRMS, relapsing-remitting multiple sclerosis; SSEP, somatosensory evoked potential.

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Jennifer,* 40 Years

IDENTIFYING PATIENT TRANSITIONS IN MULTIPLE SCLEROSIS