multiple sclerosis

Question 1

what does the affection of the CNS in MS look like ?

Answer 1

optic nerve -optic neuritis
spinal cord - myelitis
brainstem - brainstem syndrome

Question 2

what are the symptoms of optic neuritis ?

Answer 2

pain on eye movement
blurred patchy vision
central field loss
loss of color vision ( red)

Question 3

what are the signs of optic neuritis ?

Answer 3

RAPD
disc swollen
central scotoma
decreased visual acuity
Ishihara negative

Question 4

what are the symptoms of myelitis ?

Answer 4

heavy legs
tight band around the trunk
urinary frequency and urgency
constipation
sexual dysfunnction

Question 5

what is the spinal cord syndrome ?

Answer 5

UMN lesion , spastic paraplegia
gait
increased tone
brisk reflexes
sphincter dysfunction

Question 6

what is the brainstem/cerebellar syndrome ?

Answer 6

double vision
vertigo
slurred speech
unsteady gait
slurred speech
facial sensory, neuralgia

Question 7

what are the signs of brainstem or cerebellar syndromes?

Answer 7

INO internuclear ophthalmoplegia (ipsilateral affection)
nystagmus
facial paraesthesia
dysarthria

Question 8

what is lehrmittes phenomenon ?

Answer 8

when you ask the patient to bring their chin closer to their chest they feel an electric pain down their spine

Question 9

what is uhtoff’s phenomenon ?

Answer 9

symptoms increase with heat

Question 10

what are the paroxysmal MS symptoms ?

Answer 10

neuropathic pain
lehrmitte
trigeminal neuralgia
seizures
MS hug

Question 11

what is the difference between a true relapse and pseudo-relapse ?

Answer 11

true relapses last for more than 24 hours with no infection or fever
a pseudo relapse will last for more than 24 hours but will be accompanied by a fever

Question 12

what are the tests required for MS ?

Answer 12

MRI
VERs visual evoked response
CSF examination through a lumbar puncture

Question 13

where would you find MS lesions in the brain on MRI ?

Answer 13

juxtacortical
periventricular
infratentorial
spinal cord

Question 14

how can dissemination in time be confirmed ?

Answer 14

on a clinical level : 2 attacks ( the first attack plus a relapse )
on a radiological level : McDonalds MS

Question 15

what are the different disease courses of MS ?

Answer 15

Radiologically isolated syndrome ( not considered MS)
Clinically isolated syndrome
Relapsing remitting MS
Secondary progressive MS
Primary progressive MS

Question 16

what is CIS ?

Answer 16

a single attack compatible with MS , which is isolated in time and may or may not be disseminated in space usually associated with young adults

Question 17

what is RRMS ?

Answer 17

got an attack , was put on steroids then got another attack

Question 18

what is SPMS ?

Answer 18

got ann attack was given steroids and showed slight improvement then the second attack was worse

Question 19

what is PPMS ?

Answer 19

the worst prognosis
steady increase in disability without any attacks

Question 20

what do we find in the CSF of MS patients ?

Answer 20

oligoclonal bands

Question 21

if RRMS is left untreated what is the end result ?

Answer 21

SPMS

Question 22

how do we clinically asses the disease severity ?

Answer 22

EDSS
MSFC

Question 23

what does MSFC test ?

Answer 23

ambulation speed and ambulation distance

Question 24

how is cognition measures in MSFC ?

Answer 24

PASAT
symbol digit modality test
9 hole peg test

Question 25

what are the different levels for the expanded disability status scale ?

Answer 25

as soon as he needs assistance to walk - automatically at 5
restricted to wheelchair - 7
restricted to bed - 8
can’t swallow or talk - 9

Question 26

what is thee gold standard for assessing clincal disease severity ?

Answer 26

EDSS

Question 27

what are the predictors of conversion into CDMS ?

Answer 27

younger age
female patient
positive family history
cigarette smoking
cortical lesions
periventricular lesions
asympt post fossa lesions