Multiple sclerosis (MS) is a chronic, progressive, degenerative, autoimmune disease that usually follows a relapsing-remitting course. In most cases of MS, the clinical course is variable with the vast majority of patients having mild to moderate disabilities that develop over the course of years. A subset of acute forms of MS exist and may be relatively unknown to neuroscience nurses. The acute forms follow a virulent course and are associated with high morbidity and mortality. A case presentation of a patient with the Marburg variant of MS raises the neuroscience nurse's understanding of the challenges associated with caring for patients with this unusual form of MS.