Multiple Sclerosis Flashcards
What is multiple sclerosis?
Autoimmune demyelinating disorder of the CNS
Generally speaking, who gets MS?
Typically a young (20-40s) female of northern European descent
However, kids, older adults, and men can get MS too!
Geographic distribution of MS
Risk for MS increases with distance from the equator
What is the genetic predisposition for MS?
HLA-DR2
MS
Pathogenesis
Something activates the immune system to attack myelin in the CNS
T cells attach, break down, and cross the BBB
Cause progressive neurodegeneration over time
Optic Neuritis in MS
Describe the symptoms
Inflammation of the optic nerve with…
Decreased monocular vision
Pain with eye movement
Decreased Red color
Afferent pupillary defect
Internuclear Ophthalmoplegia
Where is the lesion?
Lesion in the MLF, which coordinates lateral movements of the eye
This condition is almost pathopneumonic for MS
Spinal Cord Syndrome
Describe the symptoms
Partial myelopathy
Lhermitte’s sign –> electric shock sensation with neck flexion
Numbness anywhere in the torso
Romberg Sign
What is it?
Impaired proprioception, commonly seen in MS because MS loves to affect the dorsal roots
Ask them “How do you wash your hair in the shower?”
What are the 4 locations that are considered characteristic for MS lesions?
Juxtacortical
Periventricular
Infratentorial
Spinal cord (limited to one vertebral level per lesion)
What are Dawson’s fingers?
White lesions seen on MRI –> lesions are like fingers sticking out of the corpus callosum
CSF findings in MS patients
May find Oligoclonal bands (markers of immune activity within the CNS)
Not specific, but they support an MS diagnosis
Neuromyelitis Optica
Pathology
Autoimmune process with antibodies directed against aquaporin 4 channel
Bilateral optic neuritis
Transverse myelitis
Acute Disseminated Encephalomyelitis (ADEM)
Who would get this disease? What is seen on scans?
Huge white lesions seen in a child who recently had an infection
Progressive Multiform Leukoencephalopathy
Caused by…? Symptoms?
JC virus infection of the oligodendrocytes
Causes rapidly progressing neurologic symptoms that lead to death
