L36 - MS Flashcards
optic neuritis
inflammation of the optic nerve
symptoms of optic neuritis
pain and loss of vision
prognosis of optic neuritis
- 95% return to visual acuity within 6 months with no treatment
- 50% go on to develop MS within 10 years
Lhermitte’s phenomenon
electric shock when you bend your head
inflammation of the spinal cord
traverse myelitis
prognosis of traverse myelitis
50% go on to develop MS
cause of traverse myelitis
50% due to viruses e.g., herpes zoster
symptoms of traverse myelitis
Lhermitte’s phenomenon
may affect bladder
clinically definite MS
optic neuritis and transverse myelitis at different times
not definite MS
- Clinically isolated syndrome (CIS)
- Myelitis and optic neuritis at the same time
- Recurrent myelitis
- Recurrent (same eye) or sequential (opposite eyes) neuritis
investigations of optic neuritis and transverse myelitis
lumbar puncture: abnormal antibodies present
flame lesions in MRI scan (not definite as can have within MS and not everyone with MS has)
most important thing in diagnosing MS
history
who is more prone to get MS
- women
- 30-40 year olds
- poles of the equator
what is MS
an autoimmune condition: inflammatory reaction in the CNS causing loss of myelin and slowing of nerve conduction
disease modifying treatments
- suppressing the immune system
dimethylfumarate
treats psoriasis and MS
- reduces lymphocyte count
- side effect: nausea
ataxia
loss of balance and movement
tysabri
first humanised monoclonal antibody approved treatment with MS
- inhibits adhesion molecules of the surface of immune cells
- prevents immune cells from migrating from the bloodstream to the brain
prognosis of MS
treatable but not curable
types of disease progression
- relapsing-remitting MS
- primary progressive MS
- secondary progressive MS
- progressive relapsing MS
brain in MS
shrinks
% of MS patients confined to a wheelchair within 10 years of diagnosis
15
treatment of secondary progressive MS
management of acute relapse - corticotherapy
symptoms of MS
fatigue mood problems genitosphincteral problems pain sensory problems tremor spasticity
relapsing-remitting MS
flares then relaxes
on repeat
flares get worse each time
primary progressive MS
10%
progressive
secondary progressive MS
flare up
relaxes
when it flares again, it begins to progress
progressive relapsing MS
(5%
progresses
sharp fares within this progression
each time flares, progression gets steeper
