Human disease L20 - Neurology MS and MND

Question 1

what is multiple sclerosis

Answer 1

MS is an autoimmune condition, where the myelin sheath in the brain and spinal cord are attacked, leading to patches of inflammation.

this can disrupt the messages travelling along the nerves.

It can slow them down, jumble them, send them the wrong way, or stop them getting through completely.

When the inflammation subsides, it can leave behind scarring of the myelin sheath (sclerosis).

Question 2

what is the term used when there is a loss of myelin

Answer 2

demyelination

Question 3

multiple sclerosis - epidemiology

which group of people does this predominantly affect

women or men

and the mean age

Answer 3

preominantly caucasians

women > men

mean age onset 30 years

Question 4

what do the clinical features of multiple sclerosis depend on

Answer 4

depends on area of demyelination

Question 5

what is optic neuritis

Answer 5

is the inflammation of the optic nerve, through multiple sclerosis

Question 6

is a term for a group of disorders that affect co-ordination, balance and speech. Any part of the body can be affected

Answer 6

ataxia

Question 7

there are two forms of the disease multiple sclerosis, what are they

Answer 7

1. relapsing / remitting

different areas are affected and at different times.

after an episode you will have partial / complete recovery in between

there is increasing treatment options in this variant

2. chronic progressive

cumulative damage

more disability

little treatment options compared to relapsin / remitting

Question 8

how would diganosis multiple scelerosis

Answer 8

clinical - look out for clincial features / symptoms

lumbar puncture - If you have the condition, your CSF (spinal fluid) will have higher amounts of certain proteins

MRI scan - mainstay as it allows you to clearly see the patches of demyelination

Question 9

what is this MRI scan showing

Answer 9

the MRI scan shows the area of demyelination as patches

Question 10

why are steroids used to treat multiple sclerosis

Answer 10

When taken in doses higher than the amount your body normally produces, steroids reduce redness and swelling (inflammation). This can help with inflammatory conditions such as asthma and eczema. Steroids also reduce the activity of the immune system, which is the body’s natural defence against illness and infection.

Question 11

how would you treat a pateint who has an acute relapse

Answer 11

treat with high dose steroids

Question 12

disease modifying drugs reduce relapses and slow progression of disability in relapsing remitting disease.

give two examples (from lecture)

Answer 12

betaferon and glatiramer

Question 13

which neurones are destroyed in MND

Answer 13

motor neurones

Question 14

what is the prevalence of Motor neurone disease and which sex does it affect more

Answer 14

prevalence 70 in 100 000

males>females

Question 15

what are the clinical features of motor neurone disease

Answer 15

limb weakness

swallowing problems

respiratory muscle weakness

Question 16

sadly treatment for MND is very limited, what are the best treatment options for MND

Answer 16

it is mainly supportive such as;

feeding tubes

mobility aids

specialist wheelchair

cough assist

communication aids

high levelof care in later stages of illness

Question 17

what is the prognosis for motor neurone disease

Answer 17

usually less than <5 years