Multiple Sclerosis Flashcards
What part of the nervous system does multiple sclerosis effect?
White matter of the CNS
What is multiple sclerosis?
Demyelinating disease in which the myelin sheaths of nerve cells in the brain and spinal cord are damaged
What is the process of demyelination involve?
Activated T cells cross blood brain barrier causing demyelination
Acute inflammation of myelin sheath
Loss of function
What feature is usually present with progression of multiple sclerosis?
Axonal loss
What is the most common age of onset for multiple sclerosis?
20-30 years old
What symptoms could be present during a relapse of MS?
Optic neuritis Sensory symptoms Limb weakness Brainstem diplopia Vertigo Ataxia Spinal cord symptoms Bladder problems
What are the clinical features of optic neuritis?
Subacute visual loss Pain on moving eye Colour vision disturbed Initial swelling of optic disc Optic atrophy later on Relative afferent pupillary defect
What are some of the differential diagnosis that can be made from optic neuritis?
Sarcoidosis Ischaemic optic neuropathy Neuromyelitis optica Toxic/drugs/B12 deficiency Local compression
What are the signs of myelitis?
Bladder and bowel involvement
Weakness/ UMN changes below level
Sensory level numbness or pain
What are the signs that a person with MS is has entered into the progressive phase?
Fatigue Temperature sensitivity Sensory Stiffness or spasms Slurred speech Swallowing problems Balance problems Bladder and bowel problems Cognitive dementia Diplopia
What would be found on examination of a patient with MS?
Afferent pupillary defect Nystagmus/ abnormal eye movements Cerebellar signs Weakness Spasticity Hyperreflexia Plantars extension
How is MS diagnosed?
More than 1 relapse at a different point in time
Why is gadolinium used during an MRI scan?
Shows up active areas of inflammation, separates old and new areas of inflammation
What other investigations are used to diagnose MS?
Lumbar puncture
Bloods
CXR
Visual/somatosensory evoked response
What are the different types of MS?
Relapsing remitting (RRMS) Secondary progressive (SPMS) Primary progressive (PPMS) Sensory Malignant
