Internal Medicine

0521779407-14 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:16

Multiple Sclerosis Mumps 1017

specific therapy

■Beta-interferon or copolymer reduces relapse frequency in

relapsing-remitting disease

■Cyclophosphamide, azathioprine, methotrexate, cladribine, mitox-

antrone are sometimes used in secondary progressive disease

■IV immunoglobulins may be used to reduce the attack rate in

relapsing-remitting disease

■Spasticity is treated w/ gradually increasing doses of baclofen,

diazepam or tizanidine

follow-up

■Depends on disease stage & course

■Urinary or other infections & decubitus ulcers should be treated

vigorously

complications and prognosis

■Increasing disability is likely

■Prognosis worse w/ progressive than relapsing-remitting course

■Prognosis worse w/ brain stem/cerebellar deficit

MUMPS

CAROL A. GLASER, MD

history & physical

History

■Paramyxovirus

■Humans only known natural host

■Airborne transmission, droplet spread or direct contact (from saliva

of infected person)

■Incubation period: usually 16–18 days (12–25 days)

■Most common in 5–14 years

■Reportable

■Infection adulthood, more likely to be severe

■Late winter/early spring more common

■Marked decreased incidence since introduction of vaccine in 1967

Signs & Symptoms

■Many times – asymptomatic/ “subclinical” (25–30% of cases)

➣Classic symptoms: parotid salivary glands swelling