MS pathology Flashcards
MS
Autoimmune disease , chronic progressive demyelinating of CNS and upper motor neurons
Population affected
most commonly affects white female aged between 20-40 years. unknown etiology; most likely viral.
Under normal circumstances…
oligodendrocytes produce myelin in the CNS.
the myeline insulate nerves and speeds conduction to conserve energy for nerve cells.
With MS conditions
myelin is destroyed, which means that the body cannot conserve energy for nerve cells.
demyelinating lesion slow neural transmission, which causes nerves to fatigue rapidly.
lesions are scattered, commonly in the pyramidal tract, dorsal columns, cerebrum, and cerebellum.
S/S
-Common in U/L
-Variable symptoms due to lesions being scattered at different times and places
-optic conditions
-fatigue
-spasticity, hyperreflexia, heat sensitivity
ataxic gait, intention tremor, dysmetria, dysdiadochokinesia
-cognitive conditions
-bowel and bladder conditions
-paresthesia or hyperpathia hypersensitivity
-dysphasia/dysarthria
-neuropathic pain
S/S optic conditions include
Nystagmus
optic neuritis
diplopia
Marcus Gunn pupil
nystagmus
involuntary rhythmic side to side, up and down, or circular motion.
optic neuritis
pain and temporary vision loss (commonly first symptom.)
diplopia
double vision
Treatment (eye patch)
Marcus Gunn pupil
when a light is shined in the eye, the pupil contraction is limited.
Fatigue
Muscle weakness, most commonly reported symptoms of MS
often leads to foot drop
can lead to vaulting
Ataxic gait, intention tremor, dysmetria, dysdiadochokinesia
MS can commonly affect the cerebellum which leads to these cerebellar symtpoms.
Spastic bladder
overactive bladder commonly due to hypertonic muscles
flaccid bladder
failure to empty bladder because muscles do not fully contract
dyssynergia bladder
decreased coordination between contraction and relaxation.
constipation
fewer than 3 bowel movements per week.
neuropathic pain
trigeminal neuralgia, paroxysmal limb pain (abnormal burning or aching)
neuropathic pain is from spinothalamic tract lesion.
pseudobulbar affect
involuntary emotional expression disorder
sudden and unpredictable episode of crying, laughing, or other emotional display
Lhermitte sign
experience of an electric shock sensation down the spine w/ neck flexion
Uhthoff phenomenon
increased neurological S/S due to heat. Also known as pseudo exacerbation or pseudo attack
Proper diagnosis
Evidence of damage must be present in 2 separate areas of the CNS and at 2 separate times (1 month apart)
Types of MS
relapsing-remitting
primary progressive
secondary progressive
relapsing remitting
short duration attacks with full or partial recovery
primary progressive
steady decline of function without attacks
secondary progressive
initially relapsing remitting type followed by decline of function without periods of remission.
