Falkenberg: MS

Question 1

What is this?

lesions in the CNS due to demyelination which cause scarring and areas of inflammation

Answer 1

multiple sclerosis

Question 2

What happens in MS? What’s the pathology?

Answer 2

destruction of myelin –> axonal damage –> formation of plaques, scars, lesions –>
areas of inflammation –>
infiltration of macrophages & T-cells

Question 3

In MS, there is a destruction of (blank) as well as destruction of (blank).

Answer 3

myelin; axons

Question 4

What can cause MS?

Answer 4

Genetic
Autoimmune disease
Infectious
Environmental

Question 5

MS is the most common neurological disease of young adults. What is the usu age of onset? More common in males or females?

Answer 5

20-40yrs; female:male is 2:1

Question 6

There is a strong genetic factor to MS. Pts w a first degree relative are at (blank) risk of developing MS

Answer 6

10-20x

Question 7

Common symptoms of MS?

Answer 7

visual disturbances
vertigo
limb weakness
optic neuritis *lesions in optic nerve
numbness
fatigue ** usu #1 complaint
pain

Question 8

Some disease patterns in MS

Answer 8

relapsing-remitting (75%)
secondary progressive (SPMS)
primary progressive (10-15%)
progressive-relapsing (PRMS)

Question 9

Describe the relapsing-remitting pattern of MS.

Answer 9

periods of increased and decreased disability across time

*ex: weakness in L leg last for a week to a month, & then goes away - cycle

Question 10

The geographic distribution of MS is interesting. Specifically where you lived the first 15yrs of your life. Where are most common areas w MS?

Answer 10

Northern America

Canada

Question 11

Early MS may be inflammatory, and later may be (blank).

Answer 11

degenerative

*moreso inflammatory when it’s relapsing-remitting, then progresses to degenerative

Question 12

How to diagnose MS?

Answer 12

H&P
neuro exam & MRI *lesions separated by time & space (lesions in different places cause diverse symptoms that come and go in new locations)
Spinal tap
McDonald criteria

Question 13

What will you see on an MRI if a pt has MS?

Answer 13

lesions that are changing over time

• likely to be in the optic nerve
• located around the ventricles
• can be in cerebellum, etc

Question 14

What will you find when you do a spinal tap on a pt w MS?

Answer 14

oligoclonal bands
*increased IgG causes an inflammatory response

**spinal taps done if you really aren’t sure about the diagnosis

Question 15

What is the treatment for MS?

Answer 15

to manage/decrease severity of acute attacks: steroids
manage symptoms **fatigue
modify disease course
improve physical function
psychosocial support

Question 16

General treatment of MS?

Answer 16

exercise
nutrition
rest
stress avoidance
heat avoidance
avoid infections

**symptoms get worse w hot temp, little rest, and stress