multiple sclerosis Flashcards
What is the presentation of multiple sclerosis
- Optic neuritis
- limb weakness
- diplopia
- vertigo
- bladder issues
What is the presentation of optic neuritis
- Subacute visual loss
- Painful eye movement
- colour vision impaired
What is demyelination
Autoimmune process - activated T cells cross the BBB causing the demyelination
There is acute inflammation of the myelin sheath which causes loss of function
What is the definition of multiple sclerosis
Episodes of demyelination isolated in space and time
What do black holes on the MRI show and what does that indicate
Axonal loss which is important in teh disease progression of MS
Describe primary progressive MS
No relapses and usually presents in the 5th and 6th decade - spinal and bladder symptoms
How is MS diagnosed
- Clinical - 2 relapses of MS involving different areas of CNS at different time periods
- MRI diagnosis
What do areas of demyelination look like on MRI
White lesions
What is the lumbar puncture in patients with MS
Oligoclonal bands are present in the CSF but not the serum
What is acute disseminated encephalomyelitis
Widespread demyelination which occurs in children after an infection
What is the treatment of an acute relapse of ms
Oral prednisolone
What is the symptomatic treatment for MS
- Muscle relaxants
- Antispasmodics
- gabapentin
- laxatives
What is the disease modifying treatments for MS
-IM Beta-interferons
- IM Glatiramer acetate
- oral teriflunomide
- Dimethyl fumarate
