Multiple Sclerosis and heavy metals: (a case history).(Clinical report)

History

CB, a 32-year-old woman, was diagnosed with Multiple Sclerosis in January 2004, initially presenting with optical manifestations. Her symptoms began as a central smudging effect, which evolved into complete loss of vision in the right eye and severely compromised vision in the left. Consultation with a neurologist resulted in treatment with steroids and Interferon, resulting in her vision "clearing a bit." Following this episode, her sight remained cloudy. In the autumn of 2005, she experienced several acute attacks manifesting as visual symptoms as well as tingling in the legs, which later led to difficulty with walking. She also developed abdominal spasms. She was treated with a 12-day course of steroids, which brought a slight improvement, followed by worsening after Christmas. During December, she also developed spasm in her hands with a sensation of sandpaper. Treatment with intravenous steroids brought about a minimal improvement.

Initial Presentation

At the time of initial presentation at Paracelsus Klinik in January 2006, her vision remained compromised enough to prevent reading. Right-eye vision was restricted to the perception of dim light, and in the left eye, vision was restricted to extremely large objects. She also complained of pain in the left arm and shoulder accompanied by paresthesias following an ulnar nerve distribution. In addition to the visual findings, physical examination revealed acute tenderness in the left stellate ganglion, left submandibular gland, left vagus and mastoid area, as well as left optic ganglion. Examination of the shoulder was consistent with a brachial plexus syndrome instigated by weakness in the shoulder musculature and pressure on the ulnar branch of the brachial nerve.

Lab Findings