MS, Stroke and Parkinson’s

Question 1

Describe the pathology for multiple sclerosis

Answer 1

Progressive autoimmune disorder affecting CNS myelin
Demyelinating plaques appear in white matter
Acute lesion: marked inflammatory reaction, destruction of myelin and degeneration of oligodendrocytes - relative sparing of cell body and axon

Older lesion: infiltration with macrophages, proliferation of astrocytes, laying down of fibrous tissue

Ultimately leaves a fibrous scar with no recovery potential
Axonal damage in late stages

Question 2

Describe the pathology for stroke

Answer 2

Strokes can present in many ways due to the fact that they can effect the middle cerebral artery, anterior cerebral artery or posterior cerebral artery.
If the lesion affects the primary sensory cortex, quality and intensity of sensory stimuli may be altered

if the lesion affects the motor planning area, apraxia )inability to perform a sequence of movements despite intact sensation), or brocas aphasia may occur

If the lesion affects the primary motor cortex there maybe be a loss of fractionation of movement or spasticity or flaccidity

If the lesion affects the pre frontal cortex there maybe be inappropriate or risky behaviours

If the lesion affects the parietotemporal area, communication, understanding of space, memory and emotion may be affected

Question 3

What is the pathology and effect of parkinson’s?

Answer 3

Pathology -
Death of dopamine producing cells in substantia nigra
Lewy bodies are formed within dopamine producing neurons

Effects -
Less dopamine means more inhibition of thalamus by basal ganglia so decreased voluntary movement

Excessive rigidity caused by globus pallidus—> midbrain—>reticulospinal and vestibulospinal tract pathways being interrupted

Bradykinesia

Resting tremor - pill rolling

Question 4

Name 10 clinical features seen in MS

Answer 4

Spasticity
Weakness
Bladder/bowel dysfunction
Tremor
Depression
Fatigue
Sensory issues
Reduced mobility due to coordination and balance issues
Vertigo
Sexual dysfunction

Question 5

What are the two main types of stroke?

Answer 5

Harmorrhagic and ichaemic

Question 6

What is the difference between a CNS and PNS issue?

Answer 6

CNS issues tend to cause spasticity whereas PNS issue tend to cause relaxation