Demyelinating Disorders Flashcards
What is multiple sclerosis?
Inflammatory neurodegenerative demyelinating disorder of the CNS involving deposition of plaques
Males are more commonly affected by MS than females. True/False?
False
Females 3:1 males
Which classification of MS is the most common?
Relapsing remitting
List features of pyramidal dysfunction that can occur in MS
Weakness
Spasticity
Weakness of extensors of upper limbs
Weakness of flexors of lower limbs
List features of sensory dysfunction that can occur in MS
Paraesthesia Pain Proprioception deficit Numbness Trigeminal neuralgia
List features of cerebellar dysfunction that can occur in MS
Ataxia Intention tremor Nystagmus Past pointing Pendular/floppy reflexes Dysdiadokinesis
List lower urinary tract features of MS
Frequency
Nocturia
Urgency
Retention
What therapy can be given for fatigue in MS?
Amantadine
Modafinil if sleepy
What investigations can be done for MS?
MRI
CSF
Neurophysiology
Blood tests
Blood tests are usually normal in MS. True/False?
True
What is the name given to the protein bands present on CSF electrophoresis in MS?
Oligoclonal bands
Outline treatment for acute exacerbation of MS (mild, mod, severe)
Mild: symptom relief
Mod: oral steroid
Sev: IV steroid
What therapy can help spasticity?
Physiotherapy
Anti-spasmodic (baclofen)
Botox
What therapy can help sensory symptoms?
Gabapentin
Amitryptiline
Acupuncture
Lignocaine (last-resort)
List 1st-line disease-modifying therapy for MS
Interferon-beta (avonex, extavia)
Copaxone
Tecfidira
What is the cause of Guillain-Barre syndrome?
Infections (it’s a post-infectious condition)
Weakness precedes sensory symptoms in Guillain-Barre. True or false?
False - sensory symptoms precede weakness
When are the peak symptoms in Guillain-Barre?
10-14 days into onset of illness
What is the management of Guillain-Barre?
- Immunoglobulin infusion
- Plasma exchange
What age range does MS typically affect?
30-40
What eye condition is the presenting symptom in 40% of MS cases?
Optic neuritis
List features of brain stem dysfunction that can occur in MS
Diplopia
Facial weakness
(If someone has “Bell’s palsy” and double vision it’s probably MS
What is needed for the diagnosis of MS?
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)
