Multiple Sclerosis Flashcards
Types of M.S
Primary progressive MS
Relapsing-remitting MS
Secondary Progressive MS
Rate of Primary progressive MS
5-10%
Rate of Relapsing-remitting MS?
20-30%
Rate of 2ndary progressive MS?
60%
Course of primary progressive MS?
Steady progressive with no remission
Course of relapsing-remitting MS?
relapses and remissions with no serious disability
Course of 2ndary progressive MS?
at first relapsing & remitting, later progressively deteriorating
Onset of MS?
20-40
What is MS?
Multiple demyelination of neurons
where MS affects mostly?
Optic nerve
Cerebellum
Brain stem
Spinal cord
Ocular features of MS?
- Optic neuritis (unilateral visual loss)
-Intranuclear Ophthalmoplegia (Diplopia or/and nystagmus)
-Ocular motor cranial neuropathy (sixth nerve palsy)
what does MS predominantly affects? white or grey matter?
white
F to M frequency of MS?
twice more common in F
What happens to MS as distance increases from the equator?
It inreases.
Monozygote concordance in MS?
25%
Psychiatric features of MS?
Depression
Suicide
Mania
Emotional stability
Most common psychiatric feature in MS?
Depression
Life-time prevalence of depression in MS?
25-50%
Challenge in diagnosis of depression in MS?
Somatic features of depression are not easy to distinguish from that of MS
Preferred diagnostic indicators of Depression in MS?
- Severe mood change
- Diurnal Mood
-Suicidal
-Pessimistic
-Functionally impaired not explained to motor disabilities induced by MS
First line treatment for depression in MS?
SSRIs
given the association between interferon therapy and depression in MS, what is general recommendation?
If there is history of depression, Prophylactic SSRI in those who are put on interferon
frequency of suicide in ms?
common
risk factor for suicide in MS ?
-Male
-Young onset
-Substance abuse
-Isolation
-Hx of depression
Frequency of mania in MS?
common
Which Rx if preferred over lithium to treat Mania in MS?
Mood stabilizers
Due to tolerance
recommended rx for emotional liability in MS?
SSRI
Amitriptyline
Psychiatric side effects of treatments of MS?
- 75% Affective symptoms (Mania>depression)
-50% Psychosis (hallucination)
-25% Dilirium
how long psychotic side effects of MS treatment last?
days to weeks
How long do affective side effects of MS treatments last?
Weeks to months
what MS treatments is commonly associated with anxiety and depression?
G l a t i r a m e r
Types of INF-Beta given to MS ( just for knowledge maybe)?
*INF-Beta 1A
Intramuscular Weekly or monthly
*INT-Beta 1b
subcutaneous
every other day
