CCs - in brief

Question 1

How would you define myopathy?

Answer 1

A primary disorder of the muscle with gradual-onset symmetrical proximal weakness

Question 2

What features does myopathy have?

Answer 2

Weakness
Specific muscle groups affected
Preserved tendon reflexes
No paraesthesiae or bladder problems
No fasciculations

Question 3

What are some causes of myopathies?

Answer 3

Congenital - genetic cause eg muscular dystrophies
Acquired:
Systemic disease (eg hyperthyroidism, malignancy, Cushing’s, hypo-/hypercalcaemia
Drugs (alcohol, statins, steroids, vincristine, cocaine)

Question 4

What is the pathophysiology of multiple sclerosis?

Answer 4

Inflammatory plaques of demyelination form in the CNS, occurring at multiple sites with many days between attacks
The demyelination heals poorly, eventually causing axonal loss

Question 5

How does multiple sclerosis present?

Answer 5

Mean age of onset is 30 y/o
Usually monosymptomatic
Unilateral optic neuritis (pain on eye movement, rapid loss of central vision)
Dysaesthesia
Pins and needles
Loss of vibration sense
Spastic weakness
Erectile dysfunction
Urinary incontinence / retention

Question 6

How does multiple sclerosis progress?

Answer 6

Most follow a relapsing-remitting course (recovery in-between)
As disease progresses, recovery becomes incomplete, so secondary progression occurs as disability accumulates
10% of patients show steadily progressive disease from onset