Multiple sclerosis

Question 1

Multiple sclerosis

define:

Answer 1

(MS)

also known as encephalomyelitis disseminata, is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.

This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems

Question 2

MS: recap

This type of lesion (name) may affect what?

Answer 2

A diffuse, chronic, progressive, autoimmune, inflammatory and demyelination change all over the CNS axons

Asymmetric lesion and may affect all tract of spinal cord white matter

-progressive and irreversible(due to loss of axons)

Question 3

Multiple Sclerosis

Specific symptoms include:

Answer 3

Optic Neuritis, Diplopia, ataxia,

intention tremor, muscle weakness,

dysphagia

• Charcot’s neurologic triad = nystagmus, intention tremor, dysarthria - optic neuritis – often the first sign
• Lhermitte’s sign = neck flexionelectric shock sensation radiating down the spine
• weakness, spasticity, Babinski, clonus, hyperreflexia, paraesthesia, ataxia, bladder dysfunction

Question 4

(MS)

pathophysiology:

Answer 4

• autoimmunity; type IV hypersensitivity

– attacks oligodendrocytes

Question 5

MS:

Diagnosis

Answer 5

• MRI (see sclerotic plaques in white matter)
• – the best!*
• symptoms and history
• lab tests ie. CSF containing higher WBC count and protein (particularly antibodies)

Question 6

• (MS)*
• What age group is commonly affected?*

Answer 6

most commonly begins in young adulthood

(~20-40 years old)

Question 7

MS:

Name the Risk factors and Triggers:

Answer 7

risk factors:

female, genetics (HLA-DR2), white

triggers:

infections, vitamin D deficiency

Question 8

MS

4 Types:

Answer 8

types:

• Relapsing-Remitting–(best prognosis)
• • Secondary progressive*
• • Primary progressive
• Primary relapsing*

Question 9

MS

Treatment:

Answer 9

interferon-beta: ABC (Avonext, Betaseron, Copaxone) + steroid

• immunoglobulins, plasmapheresis, recombinant IFNβ
• • physical therapy*
• newer Tx:

Glatiramer acetate, Natalizumab, Fingolimod