MS

Question 1

What is affected in MS?

Answer 1

Demyelination of oligodendrocytes

Question 2

Symptoms

Answer 2

Optic neuritis
Poor control of one leg
Ataxic paraparesis

Question 3

What is optic neuritis and differentiate this from temporal arteritis

Answer 3

Inflammatory demyelination of the optic nerve

In TA it’s painless vision loss, whereas with MS it’s painful

Question 4

What specific signs are present in MS?

Answer 4

Lhermitte’s sign

Uhthoff sign

Question 5

What is Lhermitte’s sign?

Answer 5

Electric shock sensation radiating from the neck to the legs when the neck is flexed, due to posterior cord involvement.

Question 6

What is Uhthoff’s sign?

Answer 6

This is when you get increased symptoms when you overheat, especially vision blurring

E.g. After a hot bath

Note: the heat doesn’t damage the neurons itself, but it impairs conduction temporarily

Question 7

What is seen on a brain scan for MS?

Answer 7

Plaques in angles of lateral ventricles

Question 8

Early symptoms

Answer 8

Tingling in fingers

Band like sensation in trunk or limbs

Question 9

Which side of the body will signs and symptoms be present on?

Answer 9

Symptoms typically on one side

Signs on both sides

Question 10

Why is Uhthoff’s sign especially bad? What can be done to help?

Answer 10

Exercise normally helps with MS symptoms, but also runs the risk of increasing temp and thus worsening symptoms temporarily.

Therefore patients can be advised to do pre exercise cooling and this helps them enjoy their exercise