title: Teaching case: a man with a progressive gait impairment and visual compromise.
abstract: Primary progressive multiple sclerosis can present with a wide variety of symptoms. We report a case of a 52-year-old man presenting with visual symptoms and gait impairment in whom a diagnosis of a primary progressive multiple sclerosis was established. Symptomatic treatment with dalfampridine was started but did not result in a considerable improvement. Gait disorders in multiple sclerosis are common and can have a considerable effect over the patient׳s quality of life. Dalfampridine is the first drug approved for the symptomatic treatment of gait in MS, although only a 40% of patients show an objective response to this medication. Primary progressive multiple sclerosis represents a therapeutic challenge. Currently, there are no disease modifying treatments approved but there are several medications undergoing assessment for this indication. Further research in the underlying pathophysiology of PPMS will help us develope more successful disease-modifying treatments. Meanwhile, a symptomatic approach should be offered in order to improve the patient׳s quality of life.
authors: Department of Neurology, Hospital Universitario - Fundación Santa Fe de Bogotá, Calle 119 No. 7-75, Bogotá, Colombia; School of Medicine, Universidad de Los Andes, Carrera 1 No. 18A-12, Bogotá, Colombia; School of Medicine, Universidad El Bosque, Carrera 7B Bis No. 132-11, Bogotá, Colombia. Electronic address: jtoro@uniandes.edu.co.
authors: Jaime
authors: J
authors: Toro
authors: Department of Neurology, Hospital Universitario - Fundación Santa Fe de Bogotá, Calle 119 No. 7-75, Bogotá, Colombia.
authors: Lisseth Estefania
authors: LE
authors: Burbano
authors: Department of Neurology, Hospital Universitario - Fundación Santa Fe de Bogotá, Calle 119 No. 7-75, Bogotá, Colombia; School of Medicine, Universidad El Bosque, Carrera 7B Bis No. 132-11, Bogotá, Colombia.
authors: Adrián
authors: A
authors: Zamora
authors: Department of Neurology, Hospital Universitario - Fundación Santa Fe de Bogotá, Calle 119 No. 7-75, Bogotá, Colombia; School of Medicine, Universidad El Bosque, Carrera 7B Bis No. 132-11, Bogotá, Colombia.
authors: Erica
authors: E
authors: Jones
mesh_terms: D005221:Fatigue / Q000209:etiology / Q000628:therapy; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications* / Q000628:therapy; D020335:Paraparesis / Q000209:etiology / Q000628:therapy; D014786:Vision Disorders / Q000209:etiology*
keywords: Dalfampridine; Gait disorders; Primary progresive multiple sclerosis