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Clinical case review

A man with MS asking about medicinal cannabis

William Huynh, Matthew C. Kiernan

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Abstract

A 56-year-old man with multiple sclerosis is experiencing pain, spasticity and poor sleep. Is he a candidate for medicinal cannabis and, if so, is it legal for his son to buy some for him?

Article Extract

Case scenario

Michael, aged 56 years, has chronic relapsing multiple sclerosis (MS) and walks with a frame. He has significant balance problems, reduced strength, particularly of the left leg, and experiences significant muscle cramping in his left calf and hamstring. He has also developed troublesome symptoms related to spasticity affecting the lower limbs and bladder. In addition, he sleeps poorly.

Eight months ago, Michael presented with sciatic pain radiating down the right leg and was diagnosed with facet joint arthritis affecting the right L4/5 nerve outlet. Corticosteroid injections have not improved his pain, and surgery has been deferred. Despite his balance problems, Michael has been taking pregabalin 300 mg twice daily but this also does not satisfactorily control the pain.

Picture credit: IMAGESBYBARBARA/iStockphoto.com Model used for illustrative purposes only

 

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