MS Flashcards
(35 cards)
What is MS?
- The most common primary demyelinating disease (primary – idiopathic, presumably autoimmune) of CNS
- Lesions in the white matter
- Central: oligodendrocytes
Where do demyelinating lesions of MS occur?
- anywhere in the brain and spinal cord
- constellation of SxS of almost unlimited variety
Optic Nerve
- optic neuritis (pain)
- progressive loss of visual acuity (painless)
Brainstem
- Diplopia (III, IV, VI)
- Trigeminal neuralgia (V)
- Hemifacial spasm (VII)
- Vertigo, vomiting, nystagmus (VIII)
Cerebellum and spinocerebellar path
- Dysarthria, ataxia, abnormal stance and gait
Spinal Cord
- UMN weakness, spasticity, clonus, Babinski, sensory loss (dorsal columns and anterior lateral system), bowel and bladder dysfunction
Cerebral Cortex
- intellectual impairment, memory loss, emotional changes, depression
Temporal patterns of MS
- Relapsing/remitting (most common)
- Primary progressive
- Progressive-relapsing
Relapsing/remitting MS
- Most frequent exacerbations followed by less complete recovery than in benign form
- Stable: long periods of quiescence
- Secondary Progressive: fewer remissions with disease progression (more cumulative
disability)
Primary progressive MS
- Insidious relatively late onset and steady progression of symptoms and disability.
- More lesions in SC than brain. Different inflammatory cells.
Progressive- relapsing
often diagnosed as primary first, until a relapse occurs
5 major clinical subtypes of MS
- relapsing remitting
- primary progressive
- secondary progressive
- progressive relapsing
- clinically isolated syndrome
Relapsing remitting MS characteristics
characterized by specific attack
of deficits (relapse stage) with either full or partial recovery
(remitting stage); periods between relapses characterized by lack of disease progression
Primary Progressive MS characteristics
characterized by disease
progression and a deterioration of function from onset; may have slight fluctuations but specific attacks do not occur
Secondary progressive MS characteristics
characterized by an initial
relapsing remitting stage followed by a change to a
progressive course with steady decline in function and
impairments increase with or without specific attacks
Progressive relapsing MS characteristics
characterized by steady
deterioration in disease from onset with occasional attacks-
but time between attacks has continuing progression
Clinically isolated syndrome MS characteristics
first episode of
inflammatory demyelination in the CNS that could become MS
if additional activity occurs/progression to RRM
Risk factors of MS
- female for likely for RRMS
- equal for PPMS
- Age 20-30 for RRMS
- Age 40-50 for PPMS
Etiology of MS
unknown, likely viral or autoimmune
- May have a precipitating/exacerbating factors- infection,
trauma, pregnancy, stress
characteristics of MS overall
Demyelinating lesions (plagues) impair neural
transmission, causing nerves to fatigue rapidly
Where are lesions common?
pyramidal tract, dorsal columns, optic nerve, periventricular areas of cerebrum, cerebellar peduncles
Falls in MS
- Progressive MS classification is a significant risk factor
- use of mobility aid is a significant risk factor
- consider spasticity, gait disturbances, continence, and fear
Fatigue in MS
- Common but a separate entity –> physiologic basis unknown, different fro fatigue experienced by healthy individuals
- no correlation between severity of fatigue and involvement or severity of fatigue and depression
heat sensitivity
- internal sources or external sources
