20 - Multiple Sclerosis Flashcards
What is MS
Inflammatory demyelinating and degenerative chronic disease
MS characteristic?
Current/previous neurologic symptoms/episode
Lasting at least 24 hours without evidence of infection, fever or encephalopathy
Common symptoms
Sensory/motor - Numbness/tingling, electric sensation down the back of arms or legs, useless hand syndrome
Vision - Blurriness/loss or diplopia
Slow progressive or subacute motor deficits
Rarer symptoms
Bladder dysfunction
Heat intolerance
Dementia
What is relapse-remitting MS?
Most common, flare up and then return to normal
Secondary-progressive MS?
If no treatment, will first have relapse-remitting then progressing
Primary progressive MS?
Disease keeps progressing
MRI characteristics
T2/FLAIR lesions
Lesion in corpus callosum
What is used to enhance areas of inflammation?
Contrast Gadolinium
What are you looking for in a lumbar puncture
Neurofilaments (parts of the axons) in the CSF which shows nerve loss
Diagnostic criteria
o Damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves (Dissemination in space) AND
o Find evidence that the damage occurred at two different points in time (Dissemination in time ) AND
o Rule out all other possible diagnoses
Differential diagnosis for MS
Cerebrovascular disease Syphilis SLE Vasculitis B12 def
Genetics of MS?
•Higher chance if family member has MS
•30% of twin with MS (not that high)
HLA-DR2 gene
Causes of MS?
Do not know the specific cause
Viral, mitochondrial, excitotoxicity, aggregations, infections
What is the hallmark of MS?
• Axons which are present but without myelin
