Multiple Sclerosis Flashcards
3 hallmarks of MS in histopathology
gliosis, demyelination, inflamation (infiltration of lymphocytes in perivascular cuff)
age of onset MS
10-50
most common cause of MS death
infection
risk factors MS
genes, EBV and mono, smoking, vit D deficiency
which gene very dominant driver in MS risk
HLA 2
most embarassing symptom of MS
bladder dysfunction
clinical presentation of MS (8)
Motor - spasticity, weakness and gait abnormalities.
Sensory - positive (pins & needles) and negative sensory phenomena (loss of sensation).
Cerebellum - inco-ordination and unsteady gait.
Brain Stem - diplopia, vertigo, nystagmus, dysarthria
Optic Nerves - optic neuritis (blurred vision)
Bladder and Bowel - incontinence
Higher Functions - depression, poor concentration, forgetfulness, etc.
Fatigue
what to use to assess disability in for example MS
expanded disability status scale
A 26 year old female, with previous history of myelitis, presents with double vision on looking to the left.
right mlf internuclear ophthalmoplegia
difference betwene this proesentation and 3 nerve palsy
no ptosis, no blown pupil
what about this presentation in a 70 year old lady. What is the cause likely to be
not MS, more likely a small lacunar stroke
young person with internuclear ophthalmoplegia, what very likely diagnosis
MS
where is the lesion? what other sysmptom would you expect, why?
also 7th nerve problem because 6th nerve is very close
what is optic neuritis
problem with optic nerve
what is this problem called
left afferent pupillary defect
how many types of ataxia are there. what are they
2
sensory
vestibulocerebellar
if an old ppl falls and they don’t have a broken wirst but do have a head injury, what might be wrong
test ataxia - could be parkinsons
how do you identify if a lesion is peripheral or central
Sensory: large fibre function (vibration and position sense or proprioception. Absent reflexes = peripheral neuropathy, ganglionopathy or radiculopathy; Retained reflexes = spinal cord disease.
in MS what pattern do nerves lose functions
longest ones first
what is Uthoff’s phenomenon
is a transient worsening of neurological function lasting less than 24 hours that can occur in multiple sclerosis patients due to increases in core body temperature.
what vaccinatable disease can cause myelinopathy
diphtheria
what and when do MS pts have a problem with visually
depth, at night
why do you get seizures when you heat someone up too much
sodium channels are temp dependent and go OTT when too hot
