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A 38-Year-Old Woman with Multiple Sclerosis Comes to the Office

question 334

Multiple Choice

A 38-year-old woman with multiple sclerosis comes to the office due to insomnia for the past several weeks. The patient also reports episodes of an uncomfortable "tingly" sensation in her legs associated with an urge to stretch her legs or move around. The symptoms are worse when she is lying in bed at night or when watching television or working at her computer. The patient began taking over-the-counter antihistamines to help her sleep but states she wakes up a few hours later with worsening symptoms. She feels exhausted and foggy-headed during the day. The patient is taking a stable-dose disease-modifying treatment for multiple sclerosis, and her most recent exacerbation was 2 years ago. She has no other medical conditions. Physical examination shows mildly increased lower extremity reflexes but normal muscle strength and sensations. Which of the following is the most appropriate pharmacotherapy for this patient's current symptoms?

Definitions:

Online Organizations

Entities that exist primarily on the internet, facilitating virtual collaboration, communication, and goal achievement among members.

Social Contagion

The spread of behaviors, attitudes, and emotions through groups and crowds, similar to the transmission of diseases.

Rare Blood Disease

A less common condition affecting the blood's ability to perform its key functions, such as clotting, fighting infections, or carrying oxygen to the body.

Online Support Groups

Platforms on the internet where individuals can come together to share experiences, offer support, and discuss challenges related to specific issues.