MS Flashcards
What condition is defined as a infalmmatory demyelinating disease of the CNS?
MS
What causes episodic relapses of MS?
white matter demylenation in clinically eloquent areas
how long do episodic relapses last?
hours to days, impve over weeks, possibly back to normal
What are the chronic symptoms of MS
heat sensitivity, bowel/bladder/secxual dysfunction, pain, fatigue, mood disorders, cognitive dysfunction, gait impaired.
What are the 2 most common presenting sx?
limb sensory loss 33% and optic neuritis 16%
Which condition is described as the “MS hug”
transverse myelitis
Which symptom presents as spascity, sensory level, upgoing toes, and weakness?
transverse myelitis
How do you diagnose transverse myelitis?
MRI- T2 hyperintense enhancing lesion int he cord extends over 1-2 segments.
Where are the lesions usually located in transverse myelitis?
dorsally and eccentrically on the cord.
Transverse myelitis sensory loss can only occur in one limb? t/f
false- it can be in one or both lower extremities
What are the 3 symptoms of optic neuritis?
- ipsilateral eye pain 90%
- decreased acuity
- dyschromatopsia
How would optic neuritis be diagnosed?
neuro exam
what would you find upon neuro exam of optic neuritis?
RAPD and disc edema in 1/3
What other screening can be done to see optic neuritis/
MRI- shows increased T2 signal of optic nerve
What is optic neuritis caused by?
demyelination of hte optic nerve.
How do you diagnose diplopia?
exam looking at conjugate gaze, nystagmus. or MRI visualizing lesions in brainstem/cerebellar white mater.
What are the two things needed to diagnose MS?
dissemination in space and time
What are the 4 places a lesions can occur?
periventricular
juxtacortical
infratentorial
spinal cord
T2 and FLAIR hyperintense require what criteria to be dissemination in time?
must be simultaneous enhancing lesions, or new ones that are on follow up MRI.
FLAIR imaging is good for diagnosing which type of lesions?
supratentorial lesions that are periventricular. helps distinguish them from CSF>
oligoclonal bands, elevated IgG, lymphocytes, and elevated proteins are found in what?
lumbar puncture.
What is the most useful MS screen/
visual evoked potentials.
What can VEPS identify?
increased latency showing demyelination of the optic nerve in optic neuritis.
What is the first attack of MS called?
clinically isolated syndrome
What are the 2 most common clinically isolated sydromes?
optic neuritis and transverse myelitis.
Will treating the clinically isolated syndrome help improve outcome over time?
yes. decreases disability.
What are teh treatments for MS?
IV methylprednisone or 50mg oral prednisone(higher attacks) .
- plasma exchange if steroids don’t work.
Mild sensory attacks alwyas require treatment? t/f
false- they will usually not need treatment.
treatment affects teh natural progression of the disease. t/f
false- it will not affect the history/progression of hte disease, but it will hasten the rate of recovery.
Interferons are considered what type of treatment?
disease modifying
What are the benefits to interferon treatments?
they will decrease relapse by 30%
What are the advantages to glatiramer?
no regular blood monitoring
What are the advantages to interferons?
less frequent injections, greater reduction in MRI lesions than glatriamer
What are the disadvantages to interferons?
flu lik sx, leukopenia, elevated LFT, regular blood monitoring
disadvantages to glatiramer-
most frequent injection schedule, liopatrophy at injection site. chest tightness SOB and flushing
