Multiple Sclerosis Flashcards
What is MS?
Multiple sclerosis is chronic cell-mediated autoimmune disorder characterised by demyelination in the central nervous system.
What gender is it more common in?
Women
3 times more common
What age is it usually diagnosed in?
Aged 20-40 years
What are the subtypes?
- Relapsing-Remitting Disease - most common form - 85% of patients.
- Acute attacks (1-2 months) followed by remission
- Secondary Progressive Disease
- Primary progressive Disease
What is Secondary progressive MS?
It describes relapsing-remitting patients who have deteriorated and developed neurological signs and symptoms between relapses.
What % of Relapsing-Remitting sufferers go on to get secondary progressive MS?
Around 65% of R-R go on to get this.
What neurological features are most common in secondary progressive disease?
Gait and Bladder disorders
In what group of people is primary progresive disease more common in?
Older patients
What visual symptoms do MS patients get?
- Optic neuritis: common presenting feature
- Optic atrophy
- Uhthoff’s phenomenon: worsening of vision following rise in body temperature
- Internuclear ophthalmoplegia
What sensory symptoms can they get?
- Pins/needles
- Numbness
- Trigeminal neuralgia
- Lhermitte’s syndrome: paraesthesiae in limbs on neck flexion
What motor symptom is most commonly seen in MS?
Spasticity of the legs
What cerebellar features are most commonly seen?
Ataxia and tremor
What are some other features of MS?
- Urinary incontinence
- Sexual dysfunction
- Intellectual deterioration
What are some good prognostic features in MS?
REMEMBER: Typical Patient > Atypical patient
- Female sex
- Young age of onset (i.e. 20s or 30s)
- Relapsing-remitting disease
- Sensory symptoms only
- Long interval between first two relapses
- Complete recovery between relapses
How are acute relapses managed?
High dose steroids given for ~5 days.
