MS Flashcards
What is MS?
Immune mediated disease of the central nervous system characterised by de-myelination and loss of axons
At what age is the first MS presentation most common?
20-40
Which gender is more commonly affected by MS?
Female
Which geographical region has less MS?
Near the equator
Which vitamin is thought to be involved in MS?
Vit D
Describe plaque formation in MS
Disruption of BBB allowing autoreactive T cells against myelin to get in
Inflammation subsides and incomplete healing occurs
Relapse/remission
Eventual axonal loss and degeneration
What is the criteria for MS symptoms?
Disseminated in time and space
What are the three main patterns of MS?
Relapsing remitting
Primary progressive
Secondary progressive
Describe relapsing-remitting MS
Clearly defined relapses occur with new areas of demyelination
Symptoms develop over days/weeks and resolves over weeks
Describe primary progressive MS
Slow, unstoppable disease progression with no resolution/remission
Describe secondary progressive MS
Progression continues in addition to acute flares
Acute flares are not related to disease progression
Which is the most common pattern of MS?
R-R
Which group tend to get primary progressive MS?
Older women
How is MS investigated?
MRI shows plaques in brain and spinal cord
LP shoes IgG bands
How is MS managed acutely?
High dose methylprednisolone
How is muscle spasticity in MS managed?
Baclofen
Tizanidine
Dantrolene
How is bladder dysfunction in MS managed?
Oxybutynin
Catheter
How is trigeminal neuralgia managed in MS?
Gabapentin, carbamazepine, phenytoin
How is neuropathic pain managed in MS?
Amitriptyline or gabapentin
How is fatigue managed in MS?
Amantidine
Modafinil
What long term treatment is used in relapsing remitting MS?
DMARDS
Interferon-beta mostly
Which DMARD is used in frequent or aggressive relapses of MS?
Natalizumab
