Demyelinating Disorders

Question 1

What is multiple sclerosis?

Answer 1

Inflammatory neurodegenerative demyelinating disorder of the CNS involving deposition of plaques

Question 2

Males are more commonly affected by MS than females. True/False?

Answer 2

False

Females 3:1 males

Question 3

Which classification of MS is the most common?

Answer 3

Relapsing remitting

Question 4

List features of pyramidal dysfunction that can occur in MS

Answer 4

Weakness
Spasticity
Weakness of extensors of upper limbs
Weakness of flexors of lower limbs

Question 5

List features of sensory dysfunction that can occur in MS

Answer 5

Paraesthesia
Pain
Proprioception deficit
Numbness
Trigeminal neuralgia

Question 6

List features of cerebellar dysfunction that can occur in MS

Answer 6

Ataxia
Intention tremor
Nystagmus
Past pointing
Pendular/floppy reflexes
Dysdiadokinesis

Question 7

List lower urinary tract features of MS

Answer 7

Frequency
Nocturia
Urgency
Retention

Question 8

What therapy can be given for fatigue in MS?

Answer 8

Amantadine

Modafinil if sleepy

Question 9

What investigations can be done for MS?

Answer 9

MRI
CSF
Neurophysiology
Blood tests

Question 10

Blood tests are usually normal in MS. True/False?

Answer 10

True

Question 11

What is the name given to the protein bands present on CSF electrophoresis in MS?

Answer 11

Oligoclonal bands

Question 12

Outline treatment for acute exacerbation of MS (mild, mod, severe)

Answer 12

Mild: symptom relief
Mod: oral steroid
Sev: IV steroid

Question 13

What therapy can help spasticity?

Answer 13

Physiotherapy
Anti-spasmodic (baclofen)
Botox

Question 14

What therapy can help sensory symptoms?

Answer 14

Gabapentin
Amitryptiline
Acupuncture
Lignocaine (last-resort)

Question 15

List 1st-line disease-modifying therapy for MS

Answer 15

Interferon-beta (avonex, extavia)
Copaxone
Tecfidira

Question 16

What is the cause of Guillain-Barre syndrome?

Answer 16

Infections (it’s a post-infectious condition)

Question 17

Weakness precedes sensory symptoms in Guillain-Barre. True or false?

Answer 17

False - sensory symptoms precede weakness

Question 18

When are the peak symptoms in Guillain-Barre?

Answer 18

10-14 days into onset of illness

Question 19

What is the management of Guillain-Barre?

Answer 19

• Immunoglobulin infusion

- Plasma exchange

Question 20

What age range does MS typically affect?

Answer 20

30-40

Question 21

What eye condition is the presenting symptom in 40% of MS cases?

Answer 21

Optic neuritis

Question 22

List features of brain stem dysfunction that can occur in MS

Answer 22

Diplopia
Facial weakness

(If someone has “Bell’s palsy” and double vision it’s probably MS

Question 23

What is needed for the diagnosis of MS?

Answer 23

At least 2 episodes suggestive of demyelination that are disseminated in time and place (OR a neurological defect implicating one neuro-anatomical site, and a MRI appreciated defect at another neuro-anatomical site)