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One interpretation that is often cited regarding such case reports is that these were examples of a dysmyelination resulting from a defined gene defect or an acquired/sporadic condition, with coincidental MS (Pfeffer et al., 2013

Just look at the history of people with ME (myalgic encephalomyelitis) or with Long-Covid, and how they have been ill-diagnosed and not well treated, and you realize how mediocre the specific evaluation of many people with unexplained symptoms may have been

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At these doses, you burn through a 5mg vial in about two weeks

This is a different situation from the lyophilized form