Lecure 12: Motor 2: MS: Chapter 23 Flashcards
What is MS (Multiple sclerosis)?
Chronic disorder of the central nervous system in which there is multifocal inflammation and demyelination.
What is the typical age of onset of MS?
20-40 years
It’s the most common neurlogical disorder in young adults
What is the prevalence of MS in western vs. non-western countries? Is there a gender difference?
Western: 100-200 per 100.000
Non-western: 2-10 per 100.000
Gender: 2x more common in women
What is the heritability of MS?
20-30% (twin studies)
10-15 times higher risk if a parent has MS
What are 3 factors contributing to the complex etiology of MS?
- Genetics
- Inflammation
- Lifestyle
What are 3 lifestyle factors that increase risk of MS?
- Vitamin D deficiency
- Smoking
- Obesity in childhood and adolescence
Explain the risk factor of inflammation for developing MS
Increased risks with a serious viral infection, such as epstein-barr virus
What are 3 aspects of neuropathology in MS?
- Demyelination
- Inflammation
- Neurodegeneration
What is demyelination in MS?
Loss of myelin sheath around neurons
Why does inflammation happen in MS?
Demyelination triggers autoimmune response
What is neurodegeneration in MS?
Loss of grey and white matter
With which symptom does MS typically start?
Impairment of sensory perception in the limbs or temporary problems with vision
What is the expanded disability status scale (EDSS)?
Scale that maps the severity and extent of an individual’s clinical symptoms. It measures functional decrease in 8 different functional systems of the nervous system
What are the 4 subtypes of MS describing the disease course?
- Relapse remitting (85%)
- Secondary progressive (30%)
- Primary progressive (12%)
- Progressive relapsing (less common)
What is the relapse-remitting disease course?
Loss of function, followed by recovery (flat line with bumps)
What is the secondary progressive disease course?
Relapse remitting course, followed by period without relapse, but gradual decline (flat line with bumps, after that slope with bumps)
What is the primary progressive disease course?
No relapses, but gradual decline (straight line/slope)
What is the progressive relapsing disease course?
Relapse and gradual decline (straight line/slope with bump(s))
What are 4 aspects of the clinical presentation of MS?
- Visual impairment (double vision, involuntary eye movements)
- Sensory impairment (tingling)
- Motor impairment, bladder control issues, sexual dysfunction
- (Mild) cognitive impairment, fatigue
What is the main subtype of MS?
Relapse-remitting (85%)
What is an exacerbation? How often does it occur in relapse-remitting patients?
A period of relapse in MS, where an inflammatory reaction in the myelin sheath increases symptoms
1 or 2 times per year
What is benign MS?
Disease progressing with few complaints, sometimes for decades
How does MS affect life expectancy? How do these people often die?
Life expectancy is not severely affected by MS: there is a reduction of a few years
They often die from another disease. If someone dies from MS, it’s from a severe respiratory infection or urinary tract infection
When is a positive diagnosis of MS made? (3)
- At least 2 periods with clinical symptoms
- Symptoms can be accounted for by various white matter lesions
- Complaints must not be attributable to another cause
