Multiple Sclerosis Flashcards
Causes of MS
CP of MS
(affect any area of the Brain, Optic nerve, or Spinal cord, causing almost any neurologic symptom)
- Sensory
- Motor
- Visual
- cerebellum
- Neuropsychiatric
- Genaturinary
- Fatigue
- Utthoff’s Sign
- Relapse
CP of MS
- Visual
CP of MS
- Internuclear ophthalmoplegia (INO)
CP of MS
- Sensory
CP of MS
- L’hermitte’s Sign
- Electrical sensations run down the spine when the patient bends her head forward due to lesion of the dorsal column of cervical cord or cauda medulla
CP of MS
- MS Hug
Tightening around the chest
CP of MS
- Motor
CP of MS
- Cerebellar
- Tremors
- Ataxia
CP of MS
- Neuropsychiatric
- Depression
- Irritability
- Anxiety
- Memory & Concentration Abnormalities
CP of MS
- Genaturinary
CP of MS
- Intractable Fatigue with no Other Causes
…
CP of MS
- Uthoff’s Phenomenon
Classic MS Sign
- Worsening of symptoms in the heat (hot weather, exercise, fever)
Classification of MS
Prognosis in MS
Prognosis in MS
- Good
Prognosis in MS
- Poor
Dx of MS
Dx of MS
- Apsects
- Exclude other explanations
- Prove it is M.S diagnoses
Dx of MS
- Clinical
- History and examination (all c/p not single symptom)
- Evidence of CNS involvement.
- Dissemination in space and time
Dx of MS
- INVx (Paraclinical)
- Neuroimaging.
- Evoked potentials.
- CSF analysis.
Dx Criteria of MS
Dx of MS
- MRI
Dx of MS
- Evoked Potentials
Dx of MS
- CSF Examination
CSF Examination in MS
- Sensitivity
Abnormal in 85% to 90% of patients with MS.
CSF Examination in MS
- Cells
Increased, specially during activity up to 40 cells/ mm3
CSF Examination in MS
- Total Protein
moderately Increased
CSF Examination in MS
- Gamma Globulin
Increased, especially IgG ( T total IgG, IgG ratio, IgG synthesis rate).
CSF Examination in MS
- Oligoclonal Bands
- Presence of two or more oligoclonal bands in the CS that are not present in a simultaneously drawn serum sample ICS examination
CSF Examination in MS
- IgG Index
DDx of MS
TTT of MS
TTT of MS
- Avoid PPt Factors
…
TTT of MS
- TTT of an attack (or Relapse)
TTT of MS
- Relapse Prevention (In Between Attacks)
TTT of MS
- Symptomatic
TTT of MS
- Physiotherapy
…
Disease Modifying Therapy in MS
- Intro