Clinical Perspective - Multiple Sclerosis & Demyelination Disorders Flashcards
What are the most common symptoms seen in a patient who presents with multiple sclerosis?
Numbness/tingling, fatigue, pain, difficulty walking
Multiple sclerosis onset is most often between what ages?
Ages 15-55 and more common in women than men
What is a neuro-immune disease?
A disease that is triggered and/or maintained by gross or molecular inflammation
CN II is especially at risk for multiple sclerosis-associated demyelination. Why is this?
CN II is the only cranial nerve made of CNS myelin. Vision issues are generally an early indication of MS
Activation of what T cell cellular response is responsible for the development of Multiple Sclerosis?
Th1 & Th17
How do the symptoms of multiple sclerosis present clinically?
Symptoms develop over days and resolve within weeks. Relapse of MS requires the onset of new symptoms and not the reemergence of existing symptoms
Multiple sclerosis always presents with (upper/lower) motor neuron deficits.
Upper motor neurons - MS is a CNS disease
This disease is similar to multiple sclerosis, but involves astrocytes and creates lesions primarily in the spinal cord and optic nerves.
Neuromyelitis Optica Spectrum Disorder
Myasthenia gravis and Guillan-Bare are neuro-immune diseases of the (CNS/PNS)?
PNS
What mechanisms are responsible for demyelination associated with multiple sclerosis?
Brain inflammation, alterations of ion balances and charges
What pathophysiologic changes characterize multiple sclerosis?
Inflammation, demyelination, axonal damage, gliosis
What imaging modality is required to positively diagnose multiple sclerosis?
MRI - MS cannot be diagnosed without a positive MRI that shows the presence of plaques
True/False. A lumbar puncture and MRI are required to diagnose multiple sclerosis.
False. A positive MRI is required for diagnosis, but an LP is not. An LP is only positive ~50% of the time
True/False. Multiple sclerosis begins with the development of antibodies within the CNS.
False. MS begins with antigen presentation within lymph nodes and the activation of CD4+ T cells. Activated T cells cross the BBB to enter the CNS and cause inflammation and dysregulation
What is the MOA of injectable drugs for the treatment of multiple sclerosis?
Prevent lymphocyte activation (Avonex, Betaseron, Copaxone)