Lec 13 - MS

Question 1

What is MS?

Answer 1

Myelin loss of brain and spinal cord
more common in women than men
onset between age 20-50

Question 2

Does MS prevalence increase with latitude?

Answer 2

Yes, most common in northern European descent

This is due to UV intensity

Question 3

What are the clinical signs of MS?

Answer 3

Visual impairment
Motor impairment
Sensory impairment
Cognitive/Psychiatric impairment
Bowel/Bladder impairment
Sexual impairment
Severe fatigue

Question 4

What are the causes of MS?

Answer 4

Damage to DIFFERENT parts of the brain, shown as lesions

Question 5

What are the sub-types of MS?

Answer 5

Main:
Benign MS
Relapsing remitting
Secondary progressive
Primary progressive
Progressive relapsing

Rare:
Fulminant
Concentric

Question 6

How is MS diagnosed?

Answer 6

Clinical episodes
MRI
Cerebrofluid analysis (immunoglobulin, oligoclonal)
Electrophysiology (VEP)

Question 7

What is the pathology of MS?

Answer 7

Inflammation
Demyelination
Axonal loss
Neurodegeneration
Atrophy

Greater grey matter damage, the more severe

Question 8

What cells partake in MS?

Answer 8

T-lymphocyte (early stages)

Majority of inflammatory cells in MS lesions are macrophages (MHC II) from microglia

Question 9

What is the target of this auto-immune disease?

Answer 9

Myelin proteins
Axonal/neuronal proteins
Glial proteins

Question 10

How does neurodegeneration occur?

Answer 10

Release of free radicals by inflammatory cells

Question 11

What are the treatments for MS?

Answer 11

Accute attacks (relapse) : 
High dose steroids

Prevention of relapse lesions:
Interferon-B
Glatiramer acetate
Teriflunomide
Natalizumab
Fingolimod

Symptomatic (progressive disease):
Anti-spastic drugs
Drugs to reduce neuropathic pain
Medication to improve bladder control