ArticleCureus2026
Primary Progressive Multiple Sclerosis With Acute Neurologic Deterioration Secondary to Metabolic Derangements and Medication Effects.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A 73-year-old man with a 33-year history of primary progressive multiple sclerosis (PPMS) presented with subacute gait instability, confusion, dysarthria, and severe muscle spasms. Laboratory evaluation revealed severe acute kidney injury and hypercalcemia, while noncontrast brain MRI demonstrated chronic periventricular demyelinating changes without new inflammatory lesions; contrast-enhanced MRI was not obtained. The clinical picture was most consistent with a metabolically driven pseudoexacerbation precipitated by hypercalcemia from prolonged immobilization, nephrotoxic polypharmacy, and subtherapeutic gabapentin dosing, though concurrent inflammatory PPMS activity could not be excluded. Treatment with high-dose intravenous methylprednisolone, intravenous fluid resuscitation, and calcitonin resulted in normalization of renal function and serum calcium and meaningful improvement in neurologic symptoms. This case underscores the importance of thorough systemic evaluation before attributing acute neurologic deterioration in PPMS to inflammatory relapse.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.