MS

Question 1

chronic cell-mediated autoimmune disorder
characterised by demyelination in the central nervous system.

Answer 1

Multiple Sclerosis (MS)
◙ Multiple sclerosis is chronic cell-mediated autoimmune disorder
characterised by demyelination in the central nervous system.

Question 2

Age group?
Gender predominantly?

Answer 2

◙ 3 times more common in women
◙ Most commonly diagnosed in people aged 20-40 years

Question 3

Visual sensory motor symptoms

Answer 3

Visual
Optic neuritis: common presenting feature (usually given as a hint in exam √)

Sensory
• Pins/needles
• Numbness
• Trigeminal neuralgia
• Paraesthesia in limbs on neck flexion

Motor
Spastic weakness: most commonly seen in the legs (important √)

Question 4

Other symptoms?

Answer 4

Cerebellar → Ataxia ▐ Tremors ▐ Dysarthria ▐ Nystagmus
Others
Urinary urgency/ retention
Sexual dysfunction
Intellectual deterioration

Question 5

◙ Treatment:

Answer 5

√ In acute cases (during a Relapse) (initial) → Oral or IV Methylprednisolone.
√ Long-term → Glatiramer acetate [or] Interferon-beta.

Question 6

Diagnosis?

Answer 6

◙ Diagnosis:
√ Clinical diagnosis.
√ Definitive Diagnostic test → time and place.

Question 7

Parts affected

Answer 7

Motor and Sensory symptoms due to affection of (Cerebellum + Brainstem +
Transverse Myelitis)

Question 8

Cerebellar symptoms?

Answer 8

♦ Cerebellum → Ataxia ▐ Tremors ▐ Dysarthria ▐ Nystagmus.
If limb ataxia → Cerebellar Lobe is affected.
If Truncal ataxia → Cerebellar VeRmis is affected “Midline of cerebellum”

Question 9

Brainstem?

Answer 9

Brainstem → Optic problems (Diplopia, Ophlamoplegia, Gaze palsy, blurry vision)
▐ Facial Numbness ▐ Ataxia and Dysarthria

Question 10

Transverse myelitis

Answer 10

♦ Transverse Myelitis → Weakness (e.g. in legs), Spastic Quadriparesis or Spastic
Paraparesis ▐ Urinary urgency/ retention ▐ Stiffness ▐ ↑ tone and brisk reflexes.

Question 11

Eye symptoms?
Most common part affected?

Answer 11

○ Most important hint → Optic neuritis / Pale disc / Acute unilateral visual
reduction that might be painful.

√ Note, the white matter of the optic nerve, brainstem and basal ganglia are most
commonly affected in Multiple Sclerosis.