DEMYELINATING DISEASE Flashcards
Structures affected by MS
where pial veins lie next to or within the white matter
In old lesions with interruption of axons, there
may be descending and ascending __________of long fiber tracts in the spinal cord
wallerian degeneration
four histologic subgroups of MS
Type 1-4
- T cells and macrophages
alone (pattern I); - an autoantibody lesion mediated
by immunoglobulin and complement (pattern II); - apoptosis of oligodendrocytes
and absence of immunoglobulin, complement, and with
partial remyelination (pattern III); - oligodendrocyte dystrophy and no remyelination
(pattern IV)
Most data suggest that antibody and_________ are the dominant mechanism
of demyelination in MS
complement mediated
myelin phagocytosis
Approximately _______percent of MS patients have an affected
relative, with the highest risk of concurrence being
observed in the patient’s siblings
15
The strongest association in MS is with
the DR locus on______
chromosome 6
infectious agents associated with MS
The bacterial agents Chlamydia pneumoniae
and Borrelia burgdorferi (the agent of Lyme disease) and
herpesvirus type 6
Autoantibodies have been found inconsistently that
are directed against _____ and ___
myelin oligodendrocyte glycoprotein
(MOG) and MBP
Another typical feature of MS is the temporary ind uction,
by heat or exercise, of symptoms such as unilateral
visual blurring ______
(the Uhthoff phenomenon)
A
rise of only ________) can block electrical transmission
in thinly myelinated or demyelinated fibers
0.5 C (0.9°F
__________ are all
capable of briefly worsening neurologic functioning and
are easily confused with relapses of disease.
Smoking, fatigue, hyperventilation,
and a rise in environmental temperature
These common modes of onset are
are: (1) optic
neuritis, (2) transverse myelitis, (3) cerebellar ataxia, and
(4) brainstem syndromes
When these are unaccompanied
by other features of MS, they are termed_______
“clinically
isolated syndrome” (CIS)
It is probably attributable to an increased sensitivity
of demyelinated axons to the stretch or pressure
on the spinal cord induced by neck flexion, but it occurs
in other conditions such as cervical spondylosis
Lhermitte sign
The typical relapsing-
remitting pattern of disease is more likely to appear
in patients who are younger than ______
40 years of age.
In approximately _______ of all MS patients (and
possibly in a larger proportion of children), the initial
manifestation is an episode of optic neuritis .
25 percent
ONTT findings
_______ generally taking
the form of a perceived desaturation of colors, frequently
persists as does the
______ wherein an object
such as a pendulum that is swinging perpendicular to
the patient’s line of sight, appears to moving in a threedimensional,
circular motion.
Dyschromatopsia,
Pulfrich effect,
More than ______of adult patients who present
with optic neuritis will eventually develop other signs of
MS
one-half
Clinically, the illness is characterized by a rapidly
evolving (several hours or days) symmetrical or asymmetrical
paraparesis or paraplegia, ascending paresthesia,
loss of deep sensibility in the feet, a sensory level on
the trunk, sphincteric dysfunction, and bilateral Babinski
signs.
TM
Another relatively isolated syndrome,
occurring mainly in _________ is a slowly progressive
cervical myelopathy with weakness and ataxia
older women,
The combination of nystagmus, scanning speech, and
intention tremor is known as the______
Charcot triad
A predominantly cerebellar or brainstemcerebellar
form occurs in approximately _____ percent of cases
5
It has become evident that some degree of cognitive
impairment, and probably a progressive decline,
is present in perhaps _____ of patients with longstanding
MS
one-half
Dementia in MS
As mentioned above,
the cognitive impairment is in keeping with what has
been ascribed to “subcortical dementia
