We present the case of a 42-year-old woman affected by relapsing-remitting multiple sclerosis who presented an extensive involvement of the spinal cord during the disease course. After a trial on first-line treatment, which she discontinued due to poor compliance, she was switched to intravenous ocrelizumab 600 mg every 6 months. At 10 years from the disease onset, as a result of the extensive spinal cord involvement, she began to complain of progressive and rapid reduction in ambulatory performance due to spasticity of the right leg, instability and severe fatigability, together with overactive bladder symptoms. The early introduction of nabiximols positively impacted on the patient’s symptoms and on the neurological examination, as well as on her quality of life
