MS package

Question 1

Myelin is a proteolipid sheath which covers most of the axons which conduct nerve signals. In the CNS, myelin is made by cells called

Answer 1

Oligodendrocytes

Question 2

This term is used to describe any process which resultsin myelin sheaths being lost or destroyed

Answer 2

demyelination

Question 3

This is the name given to the characteristic lesion of MS. When the disease is active, myelin destruction occur in localized patches. The stripped sections appear as greyish-coloured spots in the white matter.

Answer 3

Plaque

Question 4

This is (1) the major supporting and structural cells in CNS tissue, migrate to the site. Their role is to react to the injury by congregating together and synthesizing fiber processes to form a living scar known as (2)

Answer 4

(1)Astrocytes; (2) gliosis

Question 5

How long do the symptoms of a flare-up last for?

Answer 5

The symptoms last for 6-8 weeks, then gradually resolve over 2-3 months. Depending on the severity of the disease, the remission may return the person to normal or near normal function, or there may be considerable dysfunction

Question 6

There is a theory that at some point the person’s BBB was breached, allowing immune cells which are normally excluded to enter the CNS tissue environment. It is believed that a component of myelin called ____________ is the target of the attack.

Answer 6

Myelin Basic Protein

Question 7

What is the cause of MS?

Answer 7

MS appears to be an autoimmune disease precipitated in a genetically susceptible individual by exposure to something in the environment, likely a virus

Question 8

There are 3 factors believed to be linked to MS which are

Answer 8

1) Genetic/Inheritance
2) Geography
3) Viral

Question 9

Schumacher Criteria for definite MS

Answer 9

1) Two seperate CNS symptons
2) Two seperate attacks (separated by at least 1 month)
3) Symptoms must involve the white matter
4) Age 10-50, although usually 20-40
5) Objective deficits are present on meurological examination
6) No other medical problem exists to explain patients condition

Question 10

Factors that are predictive of a milder MS course

Answer 10

1) Early age of onset (first symptons prior to 40)
2) Sensory, as opposed to motor, symptoms at onset
3) Pattern of exacerbations and remissions as opposed to chronic progressive symptoms at onset
4) Female (males often experience more severe progression)

Question 11

Despite the unpredictability of onset of MS there are some commonalities that often seen

Answer 11

Symptoms usually appear sooner in the lower limbs and remain more severe and the limbs typically progress in asymmetrical unilateral patterns, so that each limb will likely presents differently.

Question 12

Optic Neuritis is a common visual symptom that often occurs unilaterally. The resulting impairment is usually a central blind spot in the visual field called

Answer 12

Scotoma

Question 13

Blurred vision and double vision is known as

Answer 13

Diplopia

Question 14

Eyes moving rapidly back and forth, usually horizontally, when attempting to focus on an object

Answer 14

Nystagmus

Question 15

Visual impairment experienced as jumping images

Answer 15

Oscillopsia

Question 16

Unilateral or bilateral, full or partial, failure of one eye to adduct while the other abducts

Answer 16

Internuclear opthalmoplegia

Question 17

Indicating dorsal column involvement, it is tingling sensation down the back (and sometimes the extremities) when the head is flexed forward. While usually parathetic, it can also be dysesthetic (shooting pain or electric shock feelings instead of tingling).

Answer 17

Lhermitte’s Sign

Question 18

While hearing impairments are uncommon, episodes of transitory hearing loss and ringing in the ear can occur this is also known as

Answer 18

Tinnitus

Question 19

Rapid intermittent tonic contractions, either discretely or as part of a spastic response is common, especially at the ankle this is known as

Answer 19

Clonus

Question 20

Movement hallucination, is a common experience and reflects abnormalities of cerebellar/brainstem pathways

Answer 20

Vertigo

Question 21

An involuntary rapid flickering movement of the facial muscles, is fairly typical known as

Answer 21

Facial Myokymia

Question 22

A facial muscle paralysis from loss of function in cranial nerve VII.

Answer 22

Bell’s Palsy

Question 23

Speech impairment is very common in MS. There are two primary manifestations

Answer 23

1) Dysarthria - which is a problem with control (often because of spasticity) of the muscles involved in speaking;
2) Scanning speech - each word or syllable receives equal emphasis, giving the speech a mono-tonal disconnected quality.

Question 24

Fatigue is considered one of the most disabling symptoms of MS due to the decline in conductivity of nerve fibers in the CNS also known as

Answer 24

Nerve Fiber Fatigue

Question 25

Another fatigue impairment which is a related problem which stems from the need to consciously work on functions which are normally automatic

Answer 25

Cognitive Tiring

Question 26

a sustained state of cheerfulness, happiness, and ease not based in the person’s reality, is reasonably common in more advanced cases. It is a permanent change in personality and frame of mind , as though the person has become disassociated from objective knowledge.

Answer 26

Euphoria