Lec 4

Question 1

What are th 2 types of myelin diseases in cns

Answer 1

1. Demyleinating

2. Dysmylenating

Question 2

What are demeylinating diseases of cns

Answer 2

Acquired diseases , due to toxins , drugs, autoimmune , viral infections 
MS 
Centeal pontine meylinolysis  
Neuromeylitis optica 
Post infectious demeylination

Question 3

What are dysmeylinating diseases

Answer 3

İnherited diseases where myelin is not formed properly or has abnormal turnover kinetics

Question 4

What kind of disease MS is

Answer 4

Autoimmune demylinating disease , episodes of neurologic deficits separated by time and theres white matter lesions separated by space

Question 5

Ms more common in males or females

Answer 5

Females 2:1

Question 6

İn what age MS happen

Answer 6

At any age espicially (20-40)

But rare at childhood and after 50

Question 7

What are the symptoms of MS

Answer 7

Symptoms depends on where the lesion is

They may differ after each episode

Question 8

What are the clinical course of MS

Answer 8

1 relapsing remitting
2 primary progressive
3 secondary progressive
4 progressive relapsing

Question 9

Natural history of ms

Answer 9

1. Limited regeneration in cns of meylin

2. Axonal damage can happen after repeated relapses (secondary)

Question 10

Explain the secondary axonal damage in ms

Answer 10

Usually diseases of myelin dont affect axons but repeated attacks of autoimmune destruction of meylin and associated inflammatory rxn can cause axonal damage

Question 11

What causes the loss of tolerane of self proteins of meylin in ms

Answer 11

Gentics and environment

Question 12

What is the genetic change in ms patients

Answer 12

HLA DR2

Polymorphisms in il2 il7

Question 13

What can of immunity is activated in ms and what cells

Answer 13

T cell mediated immunity
T helper
T killer
B cells

Question 14

What make us know that b cells play a role in ms

Answer 14

Oligoclonal bands in electrophoresis

B cell depletion improve symptoms

Question 15

What is the morphology of ms

Answer 15

White matter plaques well circumscribed depressed grey tan

Seen ın ventricles cerebellum spinal cord optic nerve chiasm brain stem

Question 16

What types of plaques in ms

Answer 16

1. Active , meylin breakdown , theres meylin debris in macrophages
2. Quiescent , inflammation disappear , no or little meylin ,astrocytic proliferation and gliosis

Question 17

What kind of disease is neyromeylitis optica

Answer 17

İnflammatory autoimmune demeylinating affecting optic nerve and spinal cord

Question 18

How to diagnose neuromeylitis optica

Answer 18

Anti bodies to aquaporin 4