Multiple sclerosis Flashcards
What is MS?
T4 hypersensitivity reaction vs myelin basic protein of oligodendrocytes (CNS myelinating cells)
Demyelination of CNA neurones
Rf for MS?
Female
20-40
Autoimmune disease
fHx
EBV
What are the 3 types of MS?
Relapsing-Remitting
1^ progressive
2^ progressive
What Is relapsing-remitting?
Sx , incomplete recovery, Sx ….
what is 1^ progressive MS?
Gradual deterioration without recovery
What is 2^ progressive MS?
Relapsing-remitting to 1^ progressive
-75% RR cases evolve to this
Sx of MS?
Parasthesia
Blurred vision
Uthoff’s phenomenon (Sx exacerbated with heat, after a shower)
What is the 1st presenting Sx?
optic neuritis (inflamed optic nerve + can’t see RED properly)
What other Sx would you see?
Internuclear opthalmoplegia
(lateral gaze impaired, damaged medial longitudinal fasiculus)
Brainstem signs
Sensory signs
UMN signs (not LMN)
Lhermitte’s phenomenon
(electric shock sensation with neck flexion)
Charcot neurological triad - Dysarthria, nystagmus, intention tremor
Dx of MS?
What criteria is used?
McDonalds criteria
2 or more attacks disseminated in time (separate events) + space (diff part of CNS affected)
Diagnostic for MS?
What would be seen?
MRI brain and cord
shows dissemination in space (where is white demyelination?)
+ time (give gadolinium contrast - show how long these have been there for)
What else is seen?
Delayed conduction speeds
LP may show oligoclonal IgG bands (non specific)
Tx of MS?
Acutely (in episodes) - IV methylprednisolone
Prophylaxis - Beta interferon (DMARD, Biologic)
