MS- Patho, Diagnosis, Symptoms, Types of MS Flashcards
MS definition
Chronic, autoimmune disease that affects the CNS –> myelin sheath covering of nerve fibers in the brain and spinal cord –> impairs nerves’ abilities to send electrical impulses
What is correlated with MSS disability?
Inflammation and immune activity including T and B lymphocytes, macrophages, destructive cytokines, antibodies and complement –> results in demyelination and axon damage
Factors associated with MS
Vitamin D deficiency, smoking, measles, canine distemper, human herpes-virus-6, Epstein-Barr, chlamydia pneumonia, first-degree relative with MS
MS symptoms
muscle weakness, visual symptoms, unsteady gait/balance issues, pain/paresthesias, emotional/cognitive disturbances, fatigue, sexual dysfunction, speech, swallowing, abnormal sensations, sensitivity to heat, bladder and bowel problems
MS diagnosis
At least 2 documented clinical exacerbations separated by time and space as well as 2 distinct MRI lesions separated by time and space
DIT definition
simultaneous presence of gadolinium-enhancing lesions and non-enhancing lesions or a new lesion on a follow-up MRI when compared to a previous MRI
DIS definition
distinctly different anatomical lesions on imaging occurring in areas known to be affected by MS
Poser Criteria: clinically definite MS
2 attacks and clinical evidence of 2 separate lesions
Poser Criteria: laboratory-supported definite MS
2 attacks, either clinical or paraclinical evidence of 1 lesion, and CSF immunologic abnormalities
1 attack, clinical evidence of 2 separate lesions and CSF abnormalities
Clinical evidence of 1 and paraclinical evidence of another separate lesion, CSF abnormalities
Poser Criteria: MRI findings
≥4 white matter lesions, each >3mm
≥3 white matter lesions, 1 periventricular lesion ≥6mm
Ovoid lesions oriented perpendicular to ventricles
Corpus callosum lesions
Brainstem lesions
Open ring appearance of gadolinium enhancement
Poser Criteria: CSF studies
Normal RBCs and glucose
Normal or mildly elevated protein (5-20 mononuclear cells/ul)
Intrathecal IgG synthesis, IgG index or 24 hour synthesis rate
Increased free kappa light chains
Oligoclonal bands
CIS definition
first episode of neurologic symptoms that lasts at least 24 hours
CIS is caused by what?
Inflammation and demyelination in one or more sites in the CNS
Caveat of CIS
Just because someone has CIS doesn’t mean they’ll have MS
RRMS definition
Patients experience worsening of pre-existing symptoms or onset of new symptoms for periods of ≥48 hours without concomitant fever –> relapses, flare-ups, exacerbations
Contrasted by symptom-free periods
