Demyelinating disorders Flashcards
what is the most common demyelinating disorder
multiple sclerosis
what is the secondary metabolic demyelinating disorder called
central pontine myelinosis
what kind of condition is multiple sclerosis
autoimmune
are men or women more likely to get MS
women
when do people usually present with MS
30/40s
which part of Britain has the highest incidence of MS
Orkney
what deficiency is associated with MS
vitamin D deficiency
is MS a disease of white matter or grey matter
white matter - bc only white matter contains axons (covered in myelin sheaths)
what is the pathological appearance of white matter in MS
glassy/translucent/brown appearance
which inflammatory cells are present in MS (most significant one)
oligoclonal IgG bands
which eye symptom is common (20%) in MS
unilateral optic neuritis - painful vision loss, exacerbated by eye movements
what down below symptom is common in MS
lower urinary tract dysfunction - nocturia, urgency, incontinence
what motor and sensory symptoms occur in MS
spasticity and weakness
numbness and pain
can someone get pregnant if they have MS
what would happen during pregnancy
yes
relapses actually get better
what is the Uhthoff phenomenon in MS
symptoms get worse during increase in heat - eg during exercise or shower
what are the 2 types of MS
dependent on presentation
relapsing and remitting
progressive
is there loss of sphincter tone in MS
yes
differs it from MND
what investigation do you do for MS diagnosis
what do you see
MRI - see ‘white finger’s in sagittal plane
apart from MRI, what other investigation do you do for MS
lumbar puncture electrophoresis - looking for oligoclonal IgG bands
treatment of exacerbation of MS
PO steroids (IV and admit to hospital if bad)
symptomatic treatment for MS if tired
amatidine
symptomatic treatment for MS if spasticity
baclofen
symptomatic treatment for MS if sensory problems eg neuropathic pain
amitriptyline
symptomatic treatment for MS if lower urinary tract dysfunction
catheterization
first line disease modifying drugs for MS
interferon beta (immunoglobulins)
second line disease modifying drugs for MS
monoclonal antibody (esp if relapsing and remitting)
third line disease modifying drug for MS
mitoxantrone (esp if progressive)
what condition causes bilateral severe optic neuritis
neuromyelitis optica
what is the genetic predisposition to MS
HLA DR2 (though may be idiopathic)
is MS curable
no
hence need disease modifying drugs to slow down disease process
