multiple sclerosis

Question 1

what is MS and diff types?

Answer 1

MS - chronic, autoimmune, demyelinating inflammatory disease of CNS

relapsing remitting - most common - periods of exacerbation and periods of stability

primary progressive - gradual decline over time - no relapses or remission

progressive relapsing - graduate decline + acute relapses

Question 2

active disease?

Answer 2

2 relapses in the past 2 years despite treatment with interferon beta

Question 3

relation to vit D

Answer 3

low levels of vit D can be a risk factor in developing MS
- MS patients require regular vit D after their serum vit D levels are checked

Question 4

what drugs are used to modify the course of disease?

Answer 4

DMARDs, immunomodulators, monoclonal antibodies, interferons etc.

progressive relapsing - no DMARD is licensed for this type

Question 5

Management of symptoms

Answer 5

smoking cessation - as smoking increases progression of MS

spasticity - baclofen, diazepam, tizanidine, dantrolene

relapses - methylprednisolone

oscillopsia (objects appear to vibrate) - gabapentin

mood alteration - amitriptyline

fatigue - amantadine or fampridine

Question 6

baclofen important point

Answer 6

INCREASE DOSE SLOWLY - to avoid major side effects like sedation + hypotonia