MS and Demyelinating Conditions Flashcards
who gets MS
mainly females in their 30s and 40s
clinical features of MS
pyramidal dysfunction optic neuritis sensory symptoms LUTS cerebellar and brain stem features
pyramidal dysfunction describes what features?
increased tone
spasticity
weakness in upper limb extensors and flexors of lower limbs
define optic neuritis; what pupil problem is associated with?
painful visual loss for 1-2 weeks
RAPD
sensory MS symptoms
pain paraesthesia dorsal column loss numbness trigeminal neuralgia
dorsal column loss indicates loss of what functions
proprioception
vibration
what features indicate cerebellar dysfunction?
ataxia intention tremor nystagmus dysdiadokinesis - cant perform rapid movements dysarthria - difficult speech
brain stem dysfunction will affect what nerves?
cranial nerves
what cranial nerve functions are affected in MS
diplopia
facial weakness
what is internuclear ophthalmoplegia?
eye muscle paralysis
presentation of internuclear ophthalmoplegia
distorted binocular vision cant adduct eye dipopia nystagmus lag
do MS patients tend to get FUN or SISI LUTS symptoms?
FUN
what kind of incontinence do MS patients get?
urge incontinence
Tx of fatigue in MS
amantadine
modafinil if sleepy
O2
how is MS diagnosed
2 episodes of demyelination
mcdonald criteria
MS differentials
vasculitis granulomatous disorder vascular disease infection metabolic
MS Ix
MRI
CSF
neurophysiology
blood tests
what are the mcdonald criteria for MS?
lesion in more than 1 MS typical region
presence of contrast-enhancing and/or non-contrast enhancing lesions
plasma viscosity is high in MS patients T or F
F
MS is mainly a/an ____ disorder
inflammatory
Tx of MS
DMARDs
symptomatic treatment
Tx of mild acute exacerbation of MS
symptomatic Tx
Tx of moderate acute exacerbation of MS
oral steroids
Tx of severe acute exacerbation of MS
IV steroids
will pyramidal dysfunction cause spasticity or flaccidity?
spasticity
Tx for pyramidal dysfunction
anti-spasmodic agent
Tx for spasticity
physio
baclofen
tizanidine
botox
sensory symptoms experienced by MS patients?
pain
paraesthesia
numbness
trigeminal neuralgia
how should sensory symptoms be treated in MS?
anti-convulsant eg gabapentin
anti-depressant eg amitriptyline
why do people with MS get LUTS symptoms?
increased tone at bladder neck from detrusor muscle hypersensitivity
Tx for LUTS symptoms in MS
bladder drill
oxybutynin
desmopressin
catheter
name the different kinds of MS in terms of severity
subclinical
monosymptomatic
relapsing-remitting
secondary progressive
brain volume ___ as MS progresses
decreases
first line DMARD for MS
interferon beta
second line DMARD therapy for MS
monoclonal antibodies
third line DMARD therapy for MS
mitoxantrone
interferon beta is delivered via what route
injection
first line Tx for RR MS
tecfidera
pathological process in MS?
immune cells pass through BBB
cells reactivate recruiting cytokines
immune cells attack myelin
