MS Flashcards
def
inflammatory demyelinating disease of CNS
what are the four different subtypes of MS
1 relapsing-remitting MS
2 clinically isolated syndrome
3 primary progressive MS
4 marburg variant
which is the most common subtype of MS
relapsing-remitting MS
what is relapsing-remitting MS
characterised by clinical attacks of demyelination with complete recovery in between attacks
what is clinically isolated syndrome
single clinical attack of demylination
therefore does not classify as MS
however 50% of patients will progress to MS
what is primary progressive MS
accumulation of disability with no relapsing-remitting pattern
what is marburg variant of MS
severe fulminant variant of MS
leads to advanced disabilty and death in weeks
aetiology
unknown
environmental trigger in a genetically susceptible individual initiates a T cell mediated immune response which results in discrete plaques of demyelination impairing axonal conduction
risk factors
EBV exposure
low prenatal Vit D exposure
epi
common in temperate climates (UK)
20-40yrs
females>males
history
dependent on site of inflammation but patients are usually monosymptomatic:
1 unilateral optic neuritis (common) 2 sensory -dysaesthesia -pin + needles -decreased vibration sense 3 motor -limb weakness 4 other -diplopia -urinary retention or incontinence -erectile dysfunction -anorgasmia
what is optic neuritis
unilateral deterioration in visual acuity + colour perception
pain on eye movement
what is dysaesthesia
abnormal sensation when being touched
may feel like burning
examination
1 eyes -optic neuritis (impaired visual acuity + loss of colour vision) -visual field testing (central scotoma or field defects) -relative afferent pupillary defect 2 sensory -paraesthesia (vibration and joint position sense loss is common) 3 motor -UMN signs 4 cerebellar -limb ataxia -dysdiadochokinesis -wide based gait
what would be observed in central scotoma
impaired central vision
optic nerve affected
