multiple sclerosis Flashcards
what is ms
inflammatory disorder of the central nervous system
immune cells from blood enter CNA
demylinate aoxons- loose neurons
relapses
what categorisation is there
relapsing remitting
secndary progresive
primary progressive
benign
measure disabililty using expanded disabililty scale- 1-10.
what causes MS
3:1 women to men.
some ginetic involvement, glandular fever at early age. (EBV)- cant have ms without EBV.
link with vitamin d- 5000u a day reccomended
demeyelination– remyelination–scarring– some defecit.
diagnosis of ms
mcdonal criteria
clinical symptoms
and
dissemination in space (MRI- 2 areas in brain)
and time (>1 month)- CSF oligoclonal bands counts (been some inflam in the past).
abscence of other explaination.
optic neuritis doesnt count, but should raise suspicion alot.
RX of MS
relapse: 0.5 methylpred daily for 5 days. oral (if can self care can go home)
or
1g IV 3-5/7
plasma exchenge if big remission, but very rare.
long term treatments
Disease modifying theray- interferon beta /galtiramer etc.
or highly effective ones- ocrevus.
or stem cell.
typical attack locations
optic neuritis
transverse myelitis.
brainstem- ataxia, diplopia, vertigo speech etc. mri brain for this.