MS And MND

Question 1

What is MS

Answer 1

An auto immune disease affecting the CNS as myelin is damaged

Question 2

What is an auto immune disease

Answer 2

When the immune system is directed towards the body’s own cells

Question 3

What is the average onset age for MS

Answer 3

20-30 years

Question 4

Name some genetic factors relating to MS

Answer 4

2x more women
More Caucasian
If both parents have the disease children have a 20% chance of having it

Question 5

Percentage facts about MS

Answer 5

50% after 20 years of being diagnosed will need a walking stick
50% have some cognitive involvement
Life expectancy reduced by 10-15 years

Question 6

Name some environmental factors relating to MS

Answer 6

5x more likely in colder climates
Infections can bring on onset
Vitamin D deficiencies

Question 7

Name some symptoms of MS

Answer 7

fatigue 
Visual loss 
Depression 
Tremor
Speech disturbance 
Pain

Question 8

What is the difference between primary, secondary and systemic fatigue

Answer 8

Primary- increased effort to perform tasks
Secondary- depression, sleep disturbances
Systemic- chronic lack of energy

Question 9

What is MS differentially diagnosed from and what tests are done?

Answer 9

Lyme disease 
B-12 deficiency 
Tests-
Lumbar puncture 
Neurological exam
Brain imaging

Question 10

Describe the different stages/ forms of MS

Answer 10

Primary progressive -15%
-Symptoms gradually get worse
Relapsing Remitting
-episodes occur followed by a period of some possible recovery (weeks/ months) this is the most common
Secondary Progressive
- begins as relapsing remitting but over time symptoms remain present and get worse
Progressive relapsing
- symptoms steadily get worse but episodes may or may not be followed by a period of recovery. This is the least common

Question 11

What is the difference between benign and malignant MS

Answer 11

-Malignant (acute)- progresses rapidly leading to disability in short period of time
Rare
-Benign 
15 years or more with no disability 
Little progression after first attack

Question 12

Describe MS treatment

Answer 12

• interferon beta 1a and 1b ( protein replicates human interferon)
• Glatiramer Acetate ( resembles protein in myelin)
  Drugs combined reduce relapse by 33%

Question 13

What is MND

Answer 13

When messages from neurons become less functional

Question 14

What is ALS

Answer 14

Amyotrophic lateral schlerois
Upper and lower MN signs
80% develop bulbar involvement
Speech affected before swallowing

Question 15

What is progressive bulbar palsy

Answer 15

Makes up for 20% of MND cases
Speech and swallowing early features (6-12 months complete inability to produce speech)
Life expectancy 2-4 years

Question 16

What is progressive muscular atrophy

Answer 16

Lower MN predominant
Upper MN develop at some point
Life Expectancy- 5 years

Question 17

What is primary lateral schlerosis

Answer 17

1-2% of cases 
Spastic tetraparesis 
Loss of speech within 3 years
Urinary urgency 
Long survival rate

Question 18

What is flail arm MND

Answer 18

• bilateral weakness in upper limbs
• may not spread for a number of years
• males more affected

Question 19

Lower limb onset

Answer 19

Also known as creeping paralysis

Gradual ascending distal weakness

Question 20

What drugs can be used for MND

Answer 20

Riluzole

It is a glutamate inhibitor which can prolong life by 3-6 months