Relapsing MS Clinical Challenge
Reviewed by: HU Medical Review Board | Last reviewed: September 2026 | Last updated: September 2026
Much of relapsing multiple sclerosis (MS) follow-up comes down to carefully obtaining detailed clinical history, performing comprehensive neurologic examinations, and reviewing MRI imaging to fully assess for MS disease activity. Worsening MS symptoms may be due to new inflammatory activity (a relapse), or a pseudorelapse reproducing or worsening old deficits. Disability may accrue acutely or subacutely as the result of new relapses, or gradually over time even in the absence of relapses. The oral therapies for MS have several unique monitoring and safety guidelines. These 5 questions test on all these topics.
Clinical Challenge
A patient with established relapsing-remitting MS reports return of a previously resolved right-sided weakness for the past 2 days. She has increased urinary frequency and a temperature of 38.5 degrees Celsius. What is the appropriate first step?
Clinical Challenge
In the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), which test is administered first and what does it primarily measure?
Clinical Challenge
Which finding best characterizes progression independent of relapse activity (PIRA)?
Clinical Challenge
Which statement about lymphocyte monitoring for oral MS therapies classes is accurate based on their drug labels?
Clinical Challenge
A patient on teriflunomide is planning a pregnancy within the year. Beyond stopping the drug, what is required?