Demyelination

Question 1

Pathophysiology of

MS

Answer 1

Autoreactive B and T cells

Question 2

Pathology of

MS

Answer 2

Plaques of demyelination in brain white matter, optic nerve, spinal cord

Question 3

Symptoms and features of

MS

Answer 3

Lesions fluctuate with time
Motor, sensory, and cognitive deficits as plaques affect pathways

Question 4

Pathophysiology of

Neuromyelitis optica

Answer 4

Auto antibodies to aquaporin-4 water transport protein on astrocyte endfeet

Question 5

Pathology of

Neuromyelitis Optica

Answer 5

CNS demyelination

Question 6

Symtpoms and features of

Neuromyelitis Optica

Answer 6

Optic nerve and spinal cord lesions
Absence of MRI changes in the brain

Question 7

Pathophysiology of

Guillain- Barre

Answer 7

Post infectious immune demyelinating condition affecting schwann cells

C jejuni

Question 8

Pathology of

Guillain Barre

Answer 8

Peripheral neuropathy

Question 9

Symptoms and features of

Guillain Barre

Answer 9

Ascending weakness
CN palsies
Respiratory difficulty
Motor and tactile deficits
Absent tendon reflexes

Question 10

Pathophysiology of

Charcot Marie Tooth

Answer 10

Autosomal dominant defect in schwann cell myelin synthesis due to peripheral myelin protein 22

Question 11

Pathology of

Charcot Marie Tooth

Answer 11

Peripheral demyelination and remyelination

Calf muscle atrophy

Question 12

Symptoms and features of

Charcot Marie Tooth

Answer 12

Pes cavus
Hammer toe
Foot drop
Sensory deficits
Muscle weakness

Question 13

Pathophysiology of

Central Pontine Myelinolysis

Answer 13

Rapid rate of correction of hyponatremia causes demyelination

Question 14

Pathology of

Central Pontine Myelinolysis

Answer 14

Demyelination in basal pons

Question 15

Symptoms and features of

Central Pontine Myelinolysis

Answer 15

Locked-in syndrome
Bilateral loss of all motor function below CN III

Question 16

What changes occur in CSF composition in multiple sclerosis?

Answer 16

CSF acquires IgG, myelin basic protein, and appearance of oligoclonal bands on electrophoresis analysis

Question 17

Describe the features you would expect to see in an MRI from an MS patient.

Answer 17

Plaques distributed throughout white matter and plaques bordering periventricular areas

Question 18

Describe the results of testing the pupillary light reflex in a patient with optic neuritis in one eye.

Answer 18

Affected eye: no direct or consensual response (Marcus Gunn pupil)

Unaffected eye: normal direct and consensual response

Question 19

What structure is demyelinated in internuclear ophthalmoplegia?

Answer 19

MLF

Question 20

Subtype of MS in graph A

Answer 20

Relapsing remitting

Question 21

Subtype of MS in graph B

Answer 21

Secondary progressive

Question 22

Subtype of MS in graph C

Answer 22

Primary progressive