Multiple Sclerosis Flashcards
1
Q
What is multiple sclerosis?
A
A chronic and progressive autoimmune condition with demyelination of the CNS
2
Q
What are the types of MS?
A
- Primary Progressive (more common in older)
- Secondary progressive
- Relapsing-Remitting (most common)
3
Q
What is the pathophysiology of MS?
A
- Affects the oligodendrocytes in the CNS
- Inflammation and immune cell infiltration damage the myelin
- Lesions disseminated in time and space
4
Q
What are the risk factors for MS?
A
- Women
- Multiple genes
- EBV
- Low Vit D
- Smoking
- Obesity
5
Q
How does MS first present?
A
- Optic neuritis is often the first presentation (Demyelination of the optic nerve causing unilateral visual loss developing over hours/days)
- Uhthoff’s phenomenon: Worsening of symptoms after rise in body temperature
- Internuclear opthlamoplegia
- Pins and needles/numbness in the limbs
- Lhermitte’s sign: electric shock sensation in limbs/spine upon neck flexion
- Spastic weakness
- Ataxia and tremors
6
Q
How is MS investigated?
A
- MRI which will show typical lesions
- LP to detect oligoclonal bands in the CSF
7
Q
How is MS managed?
A
- High dose steroids for relapses
- DMARDs e.g natalizumab, ocrelizumab
- Baclofen/Gabapentin for spasticity
- Amantadine for fatigue
