Multiple Sclerosis Flashcards
What is it?
- general features? (3)
- name the 4 types of clinical course that occurs in MS?
-inflammatory demyelinating disorder the CNS
-Plaques disseminated in time and place
more common in females
30s & 40s
-relapsing remitting
Secondary progressive
Progressive relapsing
Primary progressive
What are the clinical features? (7)
Pyramidal dysfunction Optic neuritis sensory symptoms Lr urinary tract dysfunction Cerebellar & brain stem features Cognitive impairment Fatigue
Pyramidal dysfunction
-what are the features? (5)
-Inc tone spasticity Weakness Extensors of the upper limbs Flexors of the lower limbs
Optic neuritis
- what is its?
- signs?
- treatment?
- painful visual loss over 1-2 wks
- blurring of vision and a RAPD
- 5 days high dose methylprednisolone
Sensory symptoms
-what are they? (5)
pain paraesthesia Dorsal column loss >> proprioception and vibration Numbness trigeminal neuralgia
Cerebellar dysfunction
-features?
Ataxia intention tremor nystagmus Past pointing Pendular reflexes Dysdiadokinesis Dysarthria
Brain stem dysfunction
-features? (2)
-Diplopia
Facial weakness
Internuclear ophthalmoplegia
-features? (5)
- Medial longitudinal fasciculus
- distortion of binocular vision
- Failure of adduction (diplopia)
- Nystagmus in abducting eye
- Lag
Lower urinary tract dysfunction?
-features (5)
frequency nocturne urgency Urge incontinance retention
how is fatigue managed? (3)
Amantadine
Modafinil if sleepy
Hyperbaric O2
What is required for a diagnosis of MS? (3)
- investigations?
- what is seen on CSF PCR?
-at least 2 episodes suggestive of demyelination
dissemination in time and place
McDonald criteria
-Clinical
+ MRI, CSF, Neurophyisology
Blood tests
-Oligoclonal bands (indicates CNS inflammation)
What would be expected on bloods? (7)
negative: PV, FBC, CRP renal liver bone profile Autoantibody screen Borellia, HIV, syphilis B12 and folate
