demylinating and dysmyelinating diseases

Question 1

What are the CSF findings for MS? What are findings for MS on MRI?

Answer 1

CSF findings: increased protein. oligoclonal bands are diagnostic. MRI findings: periventricular plaques (Dawson’s fingers) of oligo loss and reactive gliosis

Question 2

What are some treatments for MS?

Answer 2

beta-interferon, immunosuppression, nataluzimab

Question 3

How do you treat for neurogenic bladder, pain, and spasticity in MS?

Answer 3

bladder: catheterization, muscarinic antagonists
pain: opioids
spasticity: baclofen, GABA receptor agonist

Question 4

What is the classic Charcot triad of MS?

Answer 4

scaning speech, intention tremor (also incontinence and internuclear opthalmoplagia), nystagmus

Question 5

What is acute inflammatory demylinating polyradiculopathy?

Answer 5

most common variant of Guillan-Barre.

Question 6

What is the underlying problem in Guillan Barre? What cells are affected and in what pattern?

Answer 6

autoimmune condition that destroy Schwann cells. this causes inflammation and demyelination of peripheral nerves and motor fibers, causing a symmetrical ascending muscle weakness and paralysis; half of cases also reach facial paralysis

Question 7

What are some severe effects of Guillan Barre?

Answer 7

autonomics: cardiac irregularities, hypertension, hypotension. respiratory factors

Question 8

CSF findings; other findings in Guillan Barre

Answer 8

incr. CSF protein w/ normal cell count. increased protein can cause papilledema

Question 9

With what infections is Guillan Barre associated?

Answer 9

campylobacter jejuni and CMV. causes autoimmune attack from molecular mimacry

Question 10

treatment of GBS?

Answer 10

resp support. plasmaphoresis/IV immune globulins