Multiple sclerosis Flashcards
what type of disease is MS?
autoimmune disease that targets the myelin sheath in CNS (demyelination)
what type of cells are affected in MS
Oligodendrocytes cells responsible for production of myelin in CNS
MS more likely occurs in
2x more likely in women (higher prevalence in Caucasian & in colder regions)
Onset of MS most often occurs at
20-40 yrs
Etiology of MS
- unclear
- Familial tendency (15X more likely): (genetic susceptibility of immune response (MHC/HLA))
- Viral trigger causing autoimmuntiy (Epstein Barr virus)
what is the Epstein Barr virus
also known as herpes virus 4, member of herpes virus family, EBV spreads commonly through body fluids primarily saliva, EBV can cause infectious mononucleosis also called mono
what is the MHC gene and HLA gene
MHC = major histocompatiblity complex, helps immune system recognize self from foreign substances HLA= Human leukocyte antigen, gene complex encoding the MHC proteins in humans
Patho of MS
- Immune & inflammation damage causing demylenation in CNS — destruction (plaques) causing conduction problems
- oligodendrocyte necrosis
- locations vary: usually affected optic nerve, periventricular region (myelinated fibers around ventricles), Cellebrum, spinal cord, brainstem
- Lymphocyte & macrophage infiltration( aka sclerotic patches)
- motor & sensory neurons affected
what causes the sclerotic patches
lymphocyte & macrophage infiltration
Mnfts of MS vary
vary by location & extent of plaques
Mnfts of MS
- fatigue, visual impairment (usually starts unilateral @ one eye), parathesia (abnormal sensations)
- bowel & bladder dysfunction (b/c regulated from spinal cord cord)-demylinated
- decrease in muscle strength
- coordination & gait problems
- chronic exacerbation & remission
what is an important disease process for MS
Chronic exacerbation & remission :
exacerbation–comes back worse than what it was before remission, eventually remissions shorten & leave all together
Diagnosing MS
- Hx & presentation (exacterbation & remissions)
- MRI for plaques
- protiens in CSF & increased IgG
increased Protein content in CSF tells three things
- autoimmune issue in nervous system
- indicator of inflm in CSF (exudate contains protiens)
- compromised blood brain barrier (protein is a large molecule cannot pass through blood brain barrier)
Treatment of Ms
- acute relapse: steroids
- persistent relapse: interferon & methotrexate
- symptomatic – treat symptoms that may arise ex. with bowel & bladder incontinence