A 37-year-old man with recently diagnosed MS experiences sudden visual blurring in one eye with pain on upgaze. Neurological exam reveals an afferent pupillary defect and decreased visual acuity to 20/70. Brain MRI with contrast shows enhancement of the affected optic nerve. Which of the following is the most appropriate next step in management?
- A)Plasmapheresis immediately
- B)Observation without acute intervention
- C)Intravenous immunoglobulin therapy
- D)High-dose intravenous methylprednisolone followed by oral corticosteroid taperGABARITO
- E)Interferon-beta initiation
Explicação
Optic neuritis in MS is treated with high-dose IV methylprednisolone (1 g daily for 3-5 days) followed by oral prednisone taper. The ONTT trial demonstrated this accelerates visual recovery and may delay MS progression. Enhanced optic nerve on MRI confirms dem... Ver explicação completa e trilha adaptativa →