Multiple Sclerosis Flashcards
1
Q
Who is most affected by multiple sclerosis?
A
- young women (incidence is twice as high in women)
also:
- white people
- people in colder regions
2
Q
When does the onset of multiple sclerosis normally occur?
A
between 20 and 40 years
3
Q
What is the etiology of MS?
A
- unclear
- seems to be complex trait
- has a familial tendency (risk increases 50 times if you have a first degree relative with MS)
- genetic susceptibility (MHC/HLA)
- may have a viral trigger
4
Q
What type of problem is MS?
A
It is an autoimmunity problem.
5
Q
What are the manifestations of MS?
A
vary, come in pattern of exacerbation and remission:
- visual impairment
- paraesthesia
- fatigue
- bowel and bladder dysfunction
- decreased muscle strength
- gait and coordination problems
6
Q
How is MS diagnosed?
A
- history and presentation
- plaques CAN be seen via MRI
- labs to rule out other conditions
- analyze CSF (look for proteins = antibodies)
7
Q
What do proteins in CSF generally indicate?
A
1) damaged BBB
2) autoimmunity
3) inflammation
8
Q
What areas are often targeted?
A
- optic nerve
- cerebellum
- spinal cord
9
Q
What happens in MS? What is the pathophysiology?
A
- autoimmunity causes irregular targeting of oligodendrocytes and the myelin sheath in the CNS only
- inflammation follows the targeting and can damage cells further, can cause infiltration of lymphocytes and macrophages
- cells are damaged and there is necrosis of oligodendrocytes
- causes demyelination in the brain and spinal cord
- damaged areas = plaques/sclerotic patches and have conduction problems
- conduction problem can mean muscles are not stimulated… disuse can lead to atrophy
10
Q
How is MS treated?
A
- steroids for inflammation (use for acute relapses)
- methotrexate (an anticancer drug that is immunoregulatory, will need to give folic acid too)
- interferon for persistant relapses (an antiviral with immunomodulatory and anti-inflammatory properties)
- treat the symptoms
