Multiple Sclerosis Flashcards
Multiple Sclerosis
An autoimmune demyelinating disorder of the central nervous system that has relapses and remission
What is Charcot’s triad for MS?
Nystagmus, intention tremor, scanning speech
Who is the typical MS patient?
Younger females between 20 and 50 of Northern European descent
What is the regional risk for MS?
Risk of MS increases as you go further from the equator - possibly related to vitamin D levels
What is the genetic component of MS?
It is related to genetics, but it is not a genetic disease as the risk factor between identical twins is only 25%
What are some environmental factors that influence MS?
Viral exposures are connected with MS - mainly EBV
What is the pathogenesis of MS?
T cells attach to, break down and cross the BBB
– Release interleukins that cause inflammatory response and disrupt the BBB
– Secrete pro-inflammatory cytokines leading to myelin destruction and neuronal death
– Cell may become “chronically active” within the CNS over time leading to progressive neurodegeneration
What ocular problem is highly associated with MS?
Optic neuritis from inflammation of the optic nerve – Decreased monocular vision • Often involving central vision – Pain with eye movement – Decreased red/green color
What is pathopneumonic for MS?
Internuclear Ophthalmoplegia
What clinical sign can be tested for and seen in MS?
Romberg sign: a sign indicating loss of proprioceptive control in which increased unsteadiness occurs when standing with eyes closed
How is MS diagnosed using imaging?
At least one T2 lesion—that is characteristic in appearance for MS—in at least two out of four locations considered characteristic for MS: – juxtacortical – periventricular -> MAIN ONE – infratentorial – spinal cord
What will be seen in the CSF of most MS patients?
Oligoclonal bands
What can be confused with MS but will have bilateral optic neuritis instead?
Neuromyelitis Optica
Acute Disseminated Encephalomyelitis
Large multifocal lesions that is found post-infectious often in children - should not be confused with MS
Progressive Multifocal Leukoencephalopathy
Caused by JC virus and will have multiple lesions present
