Demyelinating Diseases Flashcards
In general, Demyelinating diseases damage ____ and preserve _____
Damage myelin
Preserve axons
What is an autoimmune disease that involves neuro deficits separated in time due to lesions separated in space?
Multiple Sclerosis (MS)
Multiple Sclerosis involves relapsing and remitting episodes of variable duration. What is commonly the initial symptom?
Optic Neuritis = UNILATERAL visual impairment
What are 3 genetic links that have been identified for Multiple Sclerosis?
DR2
IL-2
IL-7
What vitamin deficiency is linked to Multiple Sclerosis?
Vitamin D Deficiency
– more cases farther away from the equator
What cells initiate the chronic inflammation and react against self myelin antigens with Multiple Sclerosis?
CD4+ Th1 and Th17 = T cells
With Multiple Sclerosis, how to the plaques look and where are they usually located?
Depressed, glassy, gray-tan plaques
= Adjacent to lateral ventricles and Optic N.
What are the 3 plaque types that can be seen with Multiple Sclerosis?
- Active - ongoing myelin breakdown
- Inactive
- Shadow
Active plaques with Multiple Sclerosis are sites of ongoing myelin breakdown. What is preserved with these plaques that is NOT with Inactive plaques?
Axons are preserved with Active plaques
– Inactive plaques = Decreased axons
Shadow plaques with Multiple Sclerosis
NOT sharply circumscribed
What are the CSF findings with Multiple Sclerosis?
- INCREASED protein and IgG
- Pleocytosis (increased cells)
Oligoclonal IgG bands in the gamma region may indicated with demyelinating disease?
Multiple Sclerosis
Neuromyelitis Optica
Synchronous BILATERAL optic neuritis and spinal cord demyelination
Those with Neuromyelitis Optica may develop?
Multiple Sclerosis
With Neuromyelitis Optica, there are antibodies to?
Aquaporins
This demyelinating disease has antibodies to Aquaporins and it can be treated with Plasmapheresis
Neuromyelitis Optica
= Synchronous BILATERAL optic neuritis and spinal cord demyelination
What is found in the CSF with Neuromyelitis Optica?
Neutrophils – turbid appearance
What does Acute Disseminated Encephalomyelitis follow?
Viral infection or rarely, Viral immunization
Unlike Multiple Sclerosis, the lesions causing myelin loss with Acute Disseminated Encephalomyelitis are ____
Monophasic
This disease involves myelin loss with preservation of axons following a viral infection
Acute Disseminated Encephalomyelitis
Acute Necrotizing Hemorrhagic Encephalomyelitis is likely fatal. What does it follow?
An Upper Respiratory Infection
In what patient population is Acute Necrotizing Hemorrhagic Encephalomyelitis usually seen?
Children and young adults
This disease involves demyelination in the CNS following an Upper respiratory tract infection
Acute Necrotizing Hemorrhagic Encephalomyelitis
Where is the myelin lost from with Central Pontine Myelinolysis?
- Basis Pontis
- Portions of Pontine Tegmentum
Where is the myelin lost from with Central Pontine Myelinolysis?
- Basis Pontis
- Portions of Pontine Tegmentum
What causes Central Pontine Myelinolysis?
Overly rapid correction of Hyponatremia
What causes Central Pontine Myelinolysis?
Overly rapid correction of Hyponatremia
What are the symptoms of Central Pontine Myelinolysis?
Paralysis
Dysphagia, Dysarthria (slurred speech), Diplopia (double vision)
Loss of consciousness
If a patient presents a few days after treatment for Hyponatremia with paralysis, dysphagia, diplopia and dysarthria, what is the likely disease?
Central Pontine Myelinolysis
