Spinal cord lesions can also lead to sensory and motor deficits, including dysesthesias, spasticity, limb weakness, ataxia or other gait disturbances. Explained in a case report summary from University of Rochester Medical Center, most acute symptoms in MS are caused by spinal lesions rather than brain lesions. Dr. Gross explains that it is “not uncommon to discover multiple silent brain lesions” on MRI scans in a patient who is affected primarily with problems related to the spinal cord. These “symptomatic spinal cord lesions are [often] more difficult to identify on [MRI] scans than some clinically quiet” brain lesions .
In this randomised controlled trial, patients confirmed to have had a definite MS relapse severe enough to warrant IVMP (1 g daily for three days) were randomised to two groups. The control group was managed according to the standard ward routine; the treatment group received planned coordinated multidisciplinary team assessment and treatment. Baseline assessments, including demographics and Expanded Disability Status Scale (EDSS) were carried out on both groups. The primary outcome measures were Guy's Neurological Disability Scale (GNDS), and Amended Motor Club Assessment (AMCA). The secondary measures were the Barthel Index (BI), Human Activity Profile (HAP), and Short Form Item 36 Health Survey (SF-36). All measures have published data on reliability and validity. Measures were administered at one and three months.