MS Flashcards
Optic Neuritis - what is it?
Inflammation of the optic nerve
Optic neuritis - clinical presentation
Causes pain and loss of vision
Frequently not visible (retrobulbar)
Optic neuritis - prognosis
95% return to visual atuity of 6/12 or greater within 12 months
High dose steroids speed up rate of recovery but have no effect on final acuity
50% will develop MS within 10 years
MS - clinical presentation
Tingly numbness in feet
Gradually ascends to level around chest
Felt unsteady walking and fatigued easily
Electric shock sensations running down body when she bent her head
Transverse myelitis - what is it?
Inflammation inside the spinal cord
Transverse myelitis - clinical presentation
Often pure sensory
Lhermittes phenomenon
May affect bladder
Transverse myelitis - prognosis
Mild with good prognosis
50% will go on to develop MS
Diagnosing MS
Relies on dissemination in time and place following MacDonald criteria 2010
Clinically definitive MS - optic neuritis and transverse myelitis at different times.
Not definitive MS - clinically isolated syndrome (CIS). Myelitis and optic neuritis at same time. Recurrent myelitis or optic neuritis
MS - epidemiology
2 female to one male
30-40 yrs onset
Further away from the equator the more likely
MS - what is it?
CNS disease
Inflammatory reaction in CNS to cause loss of myelin and slowing of nerve conduction
Areas of demyelination and then loss of axons
Interferon beta affects on MS
Reduces number of relapses by a third
Effective early in the disease course
No evidence on long term effect on disability
Fingolimod
52% reduction in relapse rate compared to IM interferon 1a
2 incidences of fatal Herpes virus infection (type 1 encephalitis and disseminated Zoster)
Troublesome bradycardia after first dose
