Demyelinating Disorders (krafts) Flashcards
What is the ratio of MS in genders?
F:M 2:1
Autoimmune common ratio
What is the onset of MS?
Before 50
What are some characteristics of MS?
Episodic symptoms separated in time
Why do you get symptoms with MS?
Due to white matter lesions separated in space
What is the pathogenesis of MS?
Genetic plus enviornmental
Maybe ebstein-Barr
Linked to HLA-DR2 (DR2 is the variant that increases the likely of getting MS)
Also some link to IL-2 and IL-7 polymorphisms
T-cells against myelin and secrete cytokines
Maybe B cells play a role
What is HLA?
Human leukocyte antigen
Encode MHC
How do you diagnosis MS?
Oligoclonal bands in CSF
See immunoglobulins in the CSF in different proportions that the blood?
What is the morphology of MS?
Plaques adjacent to ventricles
Active plaques - demyelination occurring, responsible for symptoms
- T cells cuffing vessels
- axons preserved
Inactive plaque - no myelin
- decreased Oligodendrocytes
- gliosis
- decreased number of axons
How do plaques behave?
Follow blood vessels
How can you tell a plaque Histologically?
With an H&E stain
- paler
- less cellular
- lymphocytes hanging around vessels (cuffing)
What do myelin stains stain myelin?
A dark bluish purple
What is a common symptom of MS early?
Unilateral vision problems
What are clinical features of MS?
Many different symptoms
- unilateral visual impairment
- ataxia
- nystagmus
- cranial nerve signs
-motor impairment of trunk
What is acute disseminated encephalomyelitis?
ADEM
Diffuse Monophasic demyelination following a viral infection
Rapid - headache, lethargy, coma
USUALLY in children
Rare
Fatal in 10%, rest completely recover
Acute autoimmune against myelin
What is acute necrotizing hemorrhagic encephalomyelitis?
Fulminant CNS demyelination
Children and YOUNG ADULTS
Preceded by URI
Very fatal, significant defects in survivors
May be a hyper acute form of ADEM
