25. CNS Demyelinating Disease Flashcards
where does demyelinaitno occur in Intranuclear Opthalmoplegia?
Medial longitudinal fasciculus
wt is color desaturation?
associated condition?
loss of color brightness and clarity.
optic neuritis
hw does Multiple Sclerosis originate?
B and T cells in the periphery are activated, cross BBB and spread to the CNS
impaired horizontal gaze, demylinating diagnosis?
Intranuclear opthalmoplegia.
compare Natalizumab to first line MS therapies?
Natalizumab is more effective but has more severe side effects
new tx for very aggressive MS?
mech?
side effects?
Natalizumab
monoclonal antibody targeting alpha4 integrin
blocks trafficking of leukocytes across the BBB
risk of developing PML
pt presents w
3 days of blurred vision in left eye,
pain w eye movement
no other neurologic complaints
diagnosis?
optic neuritis
hw to treat acute exacerbation of multiple sclerosis?
goal of tx?
steroids
reduce time to recovery
3 abnormalities seen in CSF of pts with MS?
oligoclonal banding
high IgG/albumin ratio
elevated IgG synthesis
wt is associated w cafe au lait spots?
NF type 1
define RRMS?
SPMS?
PPMS?
RRMS
- pt has transient neurologic episodes where pt returns to baseline at end of episode. can progress to SPMS
SPMS (secondary progressive)
- pt has incomplete return to baseline after episodes
PPMS
- episodes are permanent
3 prototypical presentations of pts with MS?
- Optic Neuritis
- Intranuclear opthalmoplegia
- Transverse myelitis
presents w progressive vision loss over days and pain w extraocular movements, diagnosis?
optic neuritis
long term MS treatment that slow T2 Flair lesions in brain? other traditional MS tx?
side effects?
Interferons
AE: flu like symptoms
Glatiramer acetate
AE: injection side effects
form of MS that fials to respond to disease modifying therapy?
primary progressive MS
pt has mild MS and is on interferon, side effects of interferon are becoming too severe to continue.
wt to switch med to?
Glatiramer
in acute MS symptoms wt is the largest component to clinical presentation of symptoms?
inflammation around the nerve
demyelinaitng disease affecting optic nerves and spinal cord that is not MS?
hw to diagnose?
tx?
NEuromyelitis Optica
serum NMO IgG antibody to Aquaporin 4 Chloride Channel
Rituximab
wt is transverse myelitits?
3 symptoms?
spinal cord demyelination
hemi-sided weakness
sensory deficits
bowel dysfunction
syndrome w demyelination of medial longitudinal fasciculus?
Intranuclear Opthalmoplegia
