Multiple Sclerosis Flashcards
Who is MS MC in?
Young adult whilte females (12-50yo)
Where is MS MC?
Northern latitude & greater the farther from the equator
How do 70% of MS pts begin?
Relapsing-remitting MS
What is the duration of exacerbations or relapses?
Always >24 hours & average wks to mo & then spon gradually improve or resolve
How many exacerbations do new pt experience in the 1st year?
1-3
What do subsequent exacerbations usually implicate?
Different area of CNS disturbance
How can an exacerbation present?
Acute or subacute
What are the MC presenting exacerbations in MS?
- Parasthesia, us unilateral
- Optic neuritis
- Transverse Myelitis (LC than paraparesis)
- Vertigo
- Diplopia
- Ataxia
- Facial pain
What is Optic neuritis?
Monocular visual decrease
What is Transverse Myelitis?
Focal weakness at 1 limb or 1 side
What is the sensory disturbance distribution?
Usually not in distribution of a peripheral nerve
What is the weakness type?
UMN type & never of a single muscle
What is the cause of monocular visual decrease?
Retro-orbital
Optic disc may be inflamed
What is the most sensitive imaging for MS?
MRI w/ & w/o contrast
Where are MS plaques found?
Anywhere in the white matter of bain or myelinated SC
The ____ ____ is unaffected by MS.
Peripheral nervous system
____ ____ occur in~90% & once + remain in the ___.
CSF ABN
Pons
What are the CSF ABN of MS?
- Oligoclonal bands
- IgG index
- IgG synthesis rate
What is MS?
AI dz that targets the oligodendrocyte
What are the dz modifying drugs?
- Beta-interferons
- Glatiramer acetate (Copaxone)
- Anti-monoclonal Ab agents natalizumab (Tysabri)
- Fingolimod
- Mitoxantrone (2ndary progressive MS)
What is the management of MS?
- Corticosteroids
- Antispastic agents
- Agents for bladder spasticity
- Antidepressants
What are corticosteroids used for?
Shorten length of exacerbations
