MS, myasthenia gravis + MND Flashcards
Mean age of onset of MS + F:M ratio
30 years
F:M 3:1
Pathology of MS
Discrete plaques of demyelinations occur across CNS
Heals poorly, causing relapsing + remitting symptoms
Types of MS
Relapsing-remitting = symptoms come and go
Secondary progressive = follows on from RR. Gradually worse symptoms
Primary progressive = from beginning symptoms gradually develop
How to diagnose MS?
McDonald criteria
Lesions disseminated in time and space
Protective factors against MS
Sunlight/ Vit D
S+S MS
Unilateral optic neuritis Numbness/ tingling Leg weakness Cerebellar symptoms (diplopia/ ataxia) Sensory symptoms Sexual/ GU symptoms = sexual dysfunction, urinary retention/ incontinence Worsen with heat or exercise
Poor prognostic signs for MS
Older male, motor signs at onset, many relapses early on, many MRI lesions
Investigations for MS
Electrophysiology can detect demyelination
MRI scan
Management of MS
Methylprednisolone (less than twice a year)
Interferons
Monoclonal antibodies (Alemtuzumab)
Pathology of MND
Amyotrophic lateral sclerosis Focal in onset, usually affecting 1 group of muscles: Limb onsent Bulbar onset Respiratory onset Degeneration of upper + motor neurones
RF for MND
Male sex, increasing age, hereditary disposition
Symptoms of MND
Limb weakness = wrist drop, foot drop, gait disorder, heaviness sensation, tripping
Bulbar = slurring speech, dysphagia
Resp onset = dyspnoea + orthopnoea
Signs of MND
Wasting of muscles
LMN = Atrophy, hyporeflexiand fasciculations
UMN = hyperreflexia, hypertonia
Bulbar = wasting of tongue, emotional lability, drooling
Management of MND
Palliative
Riluzole (neuroprotective glutamate release inhibitor)
Complications of MND
Resp failure + death Aspiration pneumonia UTI Constipation Spasticity Depression Immobility
