Multiple sclerosis

Question 1

34F
diplopia - clumsiness of the left hand - numbness of the right foot + hand
CSF shows - mononuclear cell pleocytosis + oligoclonal banding

DX ??
brain findings of patieent ?

Answer 1

multiple sclerosis

oligodendrocyte depletion

Question 2

what is MS ?

Answer 2

MS is an autoimmune disorder of the central nervous system (CNS)
characterized by lesions of focal demyelination.

Question 3

result of MS ?

Answer 3

oligodendrocyte depletion

Question 4

pathogenesis of aMS ?

Answer 4

Demyelination involves both cellular and humoral immunity. Helper T cells react with myelin antigens and recruit
additional lymphocytes and macrophages. Activated CD8· T cells release cytotoxic granules that injure
oligodendrocytes. B cell recruitment leads to the formation of myelin-speci fi c antibodies that activate complement
and facilitate myelin breakdown . The result is oligodendrocyte depletion with relative sparing of axons.

Question 5

MRI of MS ?

Answer 5

oligoclonal bands

Question 6

why oligoclonal bands in MS ?

Answer 6

Oligoclonal bands
represent the intrathecal production of immunoglobulins and are highly sensitive for MS. However, oligoclonal
bands are nonspecific and may be seen in any CNS disease invo lvi ng humor al immunity (eg, vasculitis, infection).