Multiple sclerosis Flashcards
What are the main symptoms of MS?
Sensory and visual disturbance, motor impairment, bladder and bowel problems, fatigue, pain, and cognitive deficits.
What is MS?
Inflammatory autoimmune demyelinating disease of the central nervous system. Demylination heals poorly over time leading to axonal loss.
Aetiology of MS is thought to be multi factorial, including….
1) Genetic (Sex, family history)
2) Immunologic
3) Infectious (EBV)
4) Environmental/ lifestyle (Geography)
What is Lhermitte’s symptom?
Electrical sensation running down the spine on neck flexion.
What is Uhtoff’s phenomenon?
Transient disturbance of function with increase in body temperature.
What are the different types of MS?
1) Relapsing-remitting MS (RRMS)
2) Primary progressive MS (PPMS)
3) Secondary progressive MS (SPMS)
4) Progressive relapsing MS (PRMS)
What is Clinically Isolated Syndrome (CIS)?
Monophasic MS-like symptoms affecting one site or more for a 24 hour period.
How does MS show up on imaging?
White spots on MRI scan.
Identify breakdown of BBB.
What investigations are performed for suspected MS?
1) Visual Evoked Potentials (VEPs)
2) Somatosensory Evoked Potentials (SSEPs)
3) Lumbar puncture –> oligoclonal bands and high % of IgG in CSF
4) Optical Coherence Tomography (OCT)
1) The relapsing phase of the disease is considered to relate to….
2) While the progressive phase of the disease is considered to relate to….
1) Inflammation and demyelination (Relapses do NOT cause disability).
2) Atrophy, axonal loss, and increasing tissue destruction –> leads to progressive disability.
What do astrocytes do?
Form a supporting framework, have a phagocytic function, and take the place of dead neurons.
What do oligodendrocytes do?
Form myelin in CNS and influence biochemistry of neurons.
What do microglial cells do?
They are inactive in normal CNS and proliferate in disease and phagocytose.
What types of MS treatments are available?
1) Symptomatic –> Control symptoms
2) Disease modifying therapies (DMTs)
3) High dose corticosteroids –> Hasten recovery from disabling relapse
