multiple sclerosis Flashcards
multiple sclerosis affects peripheral or central ns? UMN or LMN signs?
disorder of Central NS; UMN signs
does MS affect gray or white matter more?
white matter predominantly
what is the genetic factor of MS disease
HLA class II of chromosome 6: HLA-DRBI*1501 (strongest)
Pathology of MS lesion’
what is the immunological resposne of MS lesion?
demyelination and axonal transection
activation of circulating CD4 cells specfici for myelin
Predominantenly T cell immune response. dysfunction in BBB allowing the actvated cells to cross into CNS attacking myelin
what is the most common MS
relapsing-remitting MS
what are the poor prognostic indicators
male** (men do worse than women even though it is more common in women)
older age at onset
posterior fossa symptoms at onset
African american (more aggressive agents for AA since its uncommon in AA) signficant residual disability from first attack
what is present in almost all MS patients
Ebstein Barr Virus titers
MS is common in what population?
women, caucasian, younger adults (18-55)
what is the key dx for MS
Multiple sclerosis: need MULTIPLE scarring in the CNS
SEPARATED IN TIME AND SPACE***
what is the most helpful diagnosis performed for MS
evoked potentials
Neuromyelitis Optica devic vs MS
does not get white spots in brain, 100% B cell mediated disease , where as MS is mainly T cell (some B cells)
what is the marker used to test for neuromyelitis Optica
Aquaporin-4ab (NMO-IgG): very specific, but less sensitive
where are the lesions like MS vs NMO
MS isolated to C4-patchy lesions and NMO is longitutinally extensive spinal lesions
which disease affects the pediatric population
Acute disseminated encephalomyelitis (ADEM)
which disorder COMMONLY involves gray matter of CNS
ADEM
if patient is confused, vision problem, and have SEIZURE*, what type of damage is this typically
Gray matter dysfunction–> can lead to acute disseminated encephalomyelits, because it is mainly involved with gray matter
which disorder is mainly monophasic? (one time event)
ADEM
what are the multiple sclerosis Tx
symptomatic tx, exacerbation tx(high dose steroids to shut down BBB), disease directed therapy
what should be taken to impact the immune system for MS
Vitamin D
which research focuses on axons to regenerate
nogo receptor
which medication show improvement for gaiting
AMPRYA (4-aminopyridine)
what is an important to test to help dx MS?
testing vision: optic disk edema* sign of MS
what are unique findings on MRI for MS
corpus callosum has “spots” plaques
