MS

Question 1

MS Definition

Answer 1

Chronic, Inflammatory autoimmune disorder
(brain + spinal cord)
-LOSS OF AXONS

Question 2

MS Characteristics

Answer 2

• Inflammation
• Demyelination
• Scar development (gliosis)

Question 3

MS Etiology

Answer 3

Genetic predisposition

Autoimmune: may be triggered by infection

Question 4

Risk Factors

Answer 4

20-40
Women
Moderately cool climate
Caucasian
Genetics

-Identical twin (30% Inc risk)

Question 5

Where?

Answer 5

Above 40th parallel North

Below 40th parallel South

Question 6

Possible Risk Factors

Answer 6

Smoking
Vitamin D
Obesity
Epstein-Barr

Question 7

MS Pathogenesis

Answer 7

An autoimmune attack against the MYELIN SHEATH
-T-lymphocytes migrate to CNS and cross the BBB

-Antigen-antibody reaction in CNS initiates an
inflammatory response

• Axons are de-myelinated and plaques/sclerosis forms
• AXONS ARE DESTROYED

Question 8

MS Damage

Answer 8

Loss of Sheath disrupts transmission&raquo_space;> Brain Atrophy

Question 9

Neurons in MS

Answer 9

Early:

• Nerve fibers NOT affected
• Impulses still transmitted
• May notice weakness (getting slower)

Later:

• Axons are destroyed
• Impulses are totally blocked
• Permanent loss of function

Question 10

Types of Progression

Answer 10

Benign: No disability, return to normal after attack

RRMS: Unpredictable attacks that leave permanent deficits (no return to baseline) (Progressive) MOST COMMON 80-90%
-Slow and long periods of remission

Primary Progressive: Steady increase in disability WITHOUT ATTACK (slope)
worst

Secondary-Progressive: Initial relapse-remitting, then suddenly no return to baseline between attacks

Progressive-relapsing: Steady decline with attacks linear + attacks

Question 11

How long did your latest relapse/exacerbation last

Answer 11

How we tell if patient is improving or drug is working

Question 12

MS symptoms

Answer 12

-Paresthesias (face, trunk, limbs)
-Muscle spasm
-Walking difficulty
-Fatigue
-Pain
-Urinary incontinence
…… MANY

Question 13

MS: Symptoms to monitor

Answer 13

• Cognitive problems (cog fog)
• Vision
• Depression
• Fatigue
• Pain
• Bowel/bladder
• Weakness (paralysis even)
• Sexual issues
• Muscle stiffness/spasm
• Walking/balance (vertigo)

Question 14

Goals of Therapy

Answer 14

Slow disability
Reduce freq of relapses
Reduce new brain lesions

Question 15

Drugs are used to:

Answer 15

1. Modify disease process
2. Treat an acute relapse
3. Manage symptoms