Is spinal or epidural anesthesia contraindicated in a patient with multiple sclerosis?

Abstract

An obese 31-year-old female with relapsing-remitting multiple sclerosis since the age of 23 has multiple inactive brain lesions on magnetic resonance imaging. She has no current neurologic impairment or disability. She is pregnant with twins and now presents to the labor and delivery floor with contractions. She has a mallampati class IV airway and a history of difficult intubation. What is the risk of placing a spinal/epidural anesthetic in this patient with her history of multiple sclerosis?.