MS

Question 1

What are the common examination findings?

Answer 1

Very variable, but often a young person

Pathognomonic - INO

Tone - Increased

Power - Reduced

Reflexes - Inceased

Sensation - Reduced

Co-ordination - Impatired and may have cerebellar signs

Gait may be spastic or may be in a wheelchair

Question 2

What are the investigations?

Answer 2

To finish the exam i would like to do - Upper/lower limb exam and cranial nerves

By the bed - History, obs

MRI head and spine to look for peri ventricular lesions

CF analysis - Oligoclonal bands

Evoked visual action potentials

Question 3

What are the key investigation findings?

Answer 3

Oligoclonal bands

Perventricular white matter lesions

Reduced evoked visual AP

Papilloedema

Question 4

What is the treatment?

Answer 4

• Conservative - Education, refer to MS society. MDT approach - Physio and OT
• Medical - high dose steroids or B inteferon. Also new biologics
• Treat symptoms eg baclofen for spasticity or catheter for retention

Question 5

What are the types?

Answer 5

Primary Progressive

Relapsing/Remitting

Secondary progressive