Multiple Scleroris Flashcards

1
Q

What is MS

A

an inflammatory dymelinating disorder of the CNS with plaques the disseminated in time and place

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2
Q

what is the common epidemiology of MS

A

more common in females
usually presents in 30s and 40s
more common in countries further away from the equator

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3
Q

What is the aetiogy of MS

A

Small genetic predisposition - 2 percent of people with MS have children with MS
Environment
Immune mediated

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4
Q

What are the differenty types of MS

A

Relapsing remitting - most common
Secondary progressive - 60 percent of RR pts will develop this in 10 yrs
Relapsing progressive
Primary progressive

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5
Q

What kind of symptoms can present with MS

A
pretty much anything!
Pyramidal dysfunction
Optic neuritis
sensory symptoms
Autonomic dysfunction
cerebellar and brain stem features
cognitive impairment
fatigue
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6
Q

What pydramidal dysfunction occurs in MS

A
Increased tone
Spasticity
Weakness
Extensors of upper limbs
Flexors of lower limbs
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7
Q

What is optic neuritis

A

Inflammation of optic nerve
Painful vision loss. 1-2 weeks then returns
RAPD

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8
Q

What sensory symptoms can occur

A
Pain
paraesthesia
Dorsal column loss - proprioception and vibration
Numbness
trigeminal neuralgia
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9
Q

What can occur in cerebellar symptoms

A
ataxia
intention tremor
nystagmus
past pointin
pendular reflexes
dysdiadokinesis
dysarthria
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10
Q

What brain stem dysfunction can occur

A

sixth nerve palsy –> diplopia

facial nerve palsy–> facial weakness

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11
Q

what immune cells mediate MS

A

t cells

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12
Q

what is internuclear opthalmoplegia

A

Internuclear ophthalmoplegia (INO) is a disorder of conjugate lateral gaze in which the affected eye shows impairment of adduction.

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13
Q

What is the result of internuclear opthalmoplegia

A
medial longitudinal fasciculus
distorted binocular vision
Diplopia (due to failure of adduction)
Nystagmus
Lag
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14
Q

What urinary tract dysfunctions may occur in MS

A
frequency
nocturia
urgency
urge incontinence
retention
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15
Q

How is fatigue in MS managed?

A

Amantadine
Modafinil if sleepy ( it is a eugeroic used in narcolepsy and sleep disorders)
Hyperbaric oxygen

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16
Q

What are the diagnostic criteria for MS

A

Must have at least 2 episodes suggestive of demyelination.
Dissemination in time and place.
McDonald criteria is used to diagnose MS

17
Q

What investigations are used to help diagnose MS

A

MRI
CSF
Neurophysiology ie EEG
Blood test

18
Q

What is an evoked response?

A

an electrical potential recorded from the nervous system of a human or other animal following presentation of a stimulus as detected by an EEG.

19
Q

What is VER and SSEP

A

VER= visial evoked response
SSEP= somatosensory evoked potential
VER delayed in MS

20
Q

What may be found in the CSF of MS patients

A

In 90 percent of cases there is oligoclonal bands present

Can be absent.

21
Q

What is CIS

A

clinically isolated syndrome
ie ONE episode of neurological dysfunction suggestive of demyelination
CANNOT BE MS UNLESS THERE HAVE BEEN AT LEAST 2 EPISODES- note PPMS is different