Multiple sclerosis Flashcards
1
Q
What is multiple sclerosis?
A
Chronic, progressive condition where there is demyelination of nerves in the central nervous system
2
Q
What is the pathophysiology behind MS?
A
Inflammation of the oligodendrocytes (myeline) and infiltration of immune cells cause damage and demyelination of nerves in the CNS. This then affects how the electrical signals travel along the nerves.
3
Q
Who is most commonly affected by MS?
A
- younger adults <50
- women
4
Q
What things are some risk factors / causes for MS?
A
- multiple genes
- EBV - epstein barr virus
- low vitamin D
- smoking
- obesity
5
Q
How can MS present?
A
- often is optic neuritis
- 6th cranial nerve palsy - abnormal eye movements
- focal weakness - e.g. a bell’s palsy, limb paralysis, horner’s syndrome
- focal sensory symptoms- e.g. numbness, parasthesia, trigeminal neuraldia
- may also show Charcots neurologic triad (covered on another card)
- often has a relapsing - remitting course - so flares up
6
Q
What is Charcot’s neurologic triad?
A
- dysarthria - difficulty speaking
- nystagmus
- intention tremor
7
Q
How is MS diagnosed?
A
- based on clinical picture and symptoms - episodes must have affected multiple parts of the body and there must be at least 2 episodes at seperate times
- symptoms > 1yr.
Investigations
- MRI
- lumbar puncture
8
Q
What will an MRI show in MS?
A
- white matter plaques where there is build up of myelin
9
Q
What will a lumbar puncture show in MS?
A
- ‘oligoclonal bands’ in the CSF
- high levels of antibodies
10
Q
How is MS managed?
A
- disease modifying medications and biological therapies
- treat relapses with steroids
- symptomatic management
- e.g. amitriptyline or gabapentin for neuropathic pain, antidepressants etc.
