A 34-YEAR-OLD woman was well until age 22 years, when she experienced transient numbness of both hands. At age 24 years she had her first bout of urinary incontinence, a problem that continued intermittently. At age 26 years she experienced double and "faded" vision. Subsequently, she noted the gradual development of weakness and stiffness of both legs, making walking difficult. Examination showed decreased visual acuity and pale discs on funduscopic evaluation. Tone was moderately increased in the legs, but there was only minimal weakness in distal flexors. Sensation was minimally impaired distally in the legs. Reflexes were brisk and there were bilateral Babinski's responses.Visual evoked potentials were increased in latency, right side more than left. Brain-stem auditory evoked potentials from the right ear were abnormal. Somatosensory evoked potentials were normal. Magnetic stimulation of the motor areas of the brain showed delayed motor evoked potentials in abductor pollicis
Hallett M, Cohen LG. Magnetism: A New Method for Stimulation of Nerve and Brain. JAMA. 1989;262(4):538–541. doi:10.1001/jama.1989.03430040110036
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