MS Flashcards
What is MS?
It is a neurological disorder characterised by CNS demyelination associated with inflammation
It affects approx 100,000 people in the UK and diagnosis typically occurs between the ages of 20-40
It’s 2-3 times more common in women than men
What are the possible causes of MS ?
Possible environmental factors include exposure to infections, geography (more common the further away from the the equator you are), lifestyle factors like smoking, obesity
What the four type of MS?
Relapsing remitting (most common) Secondary progressive (relapsing remitting often turns into this) Primary progressive (more common in people who get a diagnosis later in life) Progressive relapsing
What are the characteristics of relapsing remitting MS?
Involves distinct symptomatic episodes of symptoms which resolve completely or partially (later on more likely to be partial)
Symptoms are caused by demyelination of white matter fibres in the CNS, causing reduced transmission of action potentials
Symptom must be >24 hours, typically lasts for 4-6 weeks
Triggers include: infection, childbirth, increase in body temperature
What are the characteristics of secondary progressive MS?
Typically 6 months of progressive symptoms are required for diagnosis (often involves a transition period before it’s called SP MS)
What are the common symptoms of MS?
Visual disturbances Motor difficulties Sensory difficulties Autonomic dysfunction Dysarthria Dysphagia Cognitive dysfunction (particularly in later stages) Mental health difficulties
What are the specific visual symptoms of MS?
Optic neurosis (inflammation of the optic nerves) - results in loss of central vision in affected eye
Double vision
Oscillopsia - shaking eyes
What are the typical motor symptoms of MS?
motor weakness (UMN pattern) Ataxia: clumsiness and incoordination Reduced mobility Dysarthria Dysphagia
When does cognitive dysfunction occur and what are the typical symptoms?
More common in later stages of MS Difficulties with: Executive function Attention Word retrieval Visuospatial processing
How do you diagnose MS?
Can’t be done on a single symptomatic episode
Neurological test and examination is done
Blood test and lumbar puncture done to rule out different causes
MRI done for evidence of demyelination
Evoked responses - measuring electrical transmission in central auditory and visual pathway
What are the 3 areas of management of MS?
Treatment of acute relapses
Disease modifying therapy
Management of residual symptoms and disability
What is used to treat relapses?
Corticosteroids (drugs that suppress the immune system)
Given in short term to minimise side effects
Short term - increased appetite, insomnia, mood swings
Long term - weight gain, diabetes, osteoporosis
Name a type of disease modifying therapy.
How does it work?
Beta Interferon
Works by reducing the frequency and severity of relapses
Slowing down the accumulation of disability
What is the prognosis for MS?
rarely fatal but complications can arise -e.g. chest infection, swallowing difficulties, bladder infection
Average life expectancy is 5-10 years less than general population
