Control CS12 multiple sclerosis Flashcards
What is optic neuritis?
inflammation of optic nerve causing pain and loss of vision which is frequently not visible upon examination. 95% return to visual acuity 6/12 within 12 months.
What is used in the treatment of optic neuritis and why?
High dose steroids speeds up rate of recovery but has no effect on final acuity.
What percentage of patients with optic neuritis develop with MS?
50% within 10 years
What are symptoms of myelitis?
tingly numbness in feet and ascending to level of the chest like a tight band
Lhermittes phenonomen
what is myelitis?
inflammation of the spinal cord which is often mild with only sensory loss and a good prognosis
What percentage of patients with myelitis develop MS?
50%
What criteria is used to diagnose MS?
Macdonald criteria (4th revision)
When is MS a clinically definite diagnosis?
optic neuritis and (transverse) myelitis at different times
When is MS not clinically definite?
What may be seen in the brain on an MRI in MS?
proventricular flame shaped lesions
what is the epidemiology of MS?
women 2x more than men
30-40 year olds
more common in caucasians
more common further away from the equator
What is MS?
an autoimmune disease of the CNS where an inflammatory reaction causes loss of myelin and slowing of nerve conduction. There is also areas of demyelination and loss of axons
What are some examples of treatment for relapsing-remitting MS?
Dimethyl fumerate
IV methylyprednisolone
TYSABRI aka natalizumab - safe to take for 2 years in severe MS
Fingolimod
Ocrevus aka ocrelizumab (1x IV infusion every 6 months)
What does taking natalizumab increase your risk of?
Progressive multifocal leukoencephalopathy caused by JC virus. Not usually a problem in healthy people but detrimental in those with MS
what percentage of MS patients are confined to a wheelchair within 10 years of diagnosis?
15%
