Multiple sclerosis Flashcards
Demyelination in MS may progress in 2 ways, what are these?
It mat involve relapsing and remitting symptoms
It may involve clinically progressive symptoms
Who gets MS?
More common in females
Typically presents age 30-40
What are some of the sensory clinical features of MS?
Pain
Paraesthesia
Impaired proprioception
Trigeminal neuralgia
What are some of the motor symptoms of MS, due to pyramidal dysfunction?
Increased tone and spasticity
Weakness
NB affects the extensors of the upper limbs and the flexors of the lower limbs
What are some of the motor symptoms of MS which are due to cerebellar dysfunction?
Ataxia
Intention tremor
Pendular reflexes
Dysdiadokinesis
Dysarthria
Past pointing
How can MS affect the eyes?
Optic neuritis
Internuclear ophthalmoplegia
Nystagmus
Diplopia
How can MS affect the GI and GU systems?
Swallowing disorders
Constipation
Bladder dysfunction
Erectile dysfunction
What things can worsen symptoms in MS?
Exercise and heat
What are the criteria for diagnosis of MS?
2+ episodes of demyelination must be disseminated in time and place
Multiple distinct CNS lesions on MRI
What CSF signs are supportive of MS?
IgG oligoclonal bands
CSF clear
Normal opening pressure
What investigations can be done for MS?
MRI
LP
Blood tests
McDonalds criteria
What signs on MRI are supportive for MS?
Hyperintesnse regions (showing white matter demyelination)
What are some of the causes/ associations with MS?
Northern latitudes
HLADRB1
TH1 and TH17
What is the difference between active and inactive plaques in MS?
Active plaques
- ongoing inflammation and demyelination
- plaques are ill-defined and blend into the surrounding white matter
Inactive plaques
- gliosis predominates
- plaques are well demarcated and typically situated around the lateral ventricles
How is mild MS managed?
Symptomatic treatment
