Multiple Sclerosis

Question 1

what is multiple sclerosis

Answer 1

chronic and progressive autoimmune condition involving demyelination in the central nervous system

Question 2

brief pathophysiology of MS

Answer 2

loss of myelin (of oligodendrocytes) slows transmission of signals
causes symptoms
in early disease partial re-myelination can occur
scar tissue can form (plaques) which further interupts signalling

Question 3

what are some predisposing factors for MS

Answer 3

genetic
EBV
smoking and obesity
F>M
<50

Question 4

how might MS present

Answer 4

1. motor (weakness, spacticity, tremor)
2. sensory (trigeminal neuralgia, ataxia, pins and needles)
3. bulbar
4. visual (optic neuritis, diplopia, pain, internuclear opthalmoplegia)
5. mood and cognition

Question 5

what phenomenon may be seen in MS

Answer 5

Uhthoff phenomenon
deterioration of symptoms in higher temperature

Question 6

time scale for a flare of MS

Answer 6

symptoms generally progress over 24 hours
may last days to week before improving

Question 7

what are the different patterns of disease for MS

Answer 7

clinically isolated syndrome
relapsing and remitting
primary progressive
secondary progressive

Question 8

what may be seen in lumbar puncture to support diagnosis of MS

Answer 8

oligoclonal bands

Question 9

what can be used to manage acute flares of MS

Answer 9

high dose methylprednisolone for 5 days
shortens relapse but doesn’t improve recovery

Question 10

what medications can be used to induce remission in MS

Answer 10

DMARDS