Multiple Sclerosis

Question 1

What are T cells activated by in multiple sclerosis?

What does this result in?

Type of hypersensitivity reaction?

Answer 1

Myelin

Increased expression of receptors for ligands on BBB permitting more T cells to enter the CNS
Cytokine release - dilation of blood vessels - more immune cells enter (B cells and macrophages)
B cells mark oligodendrocytes - macrophages phagocytose myelin - leave plaques (sclera)

IV
.

Question 2

Why does the damage eventually become irreversible?

Answer 2

Initially regulatory T cells enter to stunt the immune response so remyelination occurs
Eventually the oligodendrocytes are completely destroyed meaning no remyelination can occur.

Question 3

Which HLA associated?

Deficiency of?

Answer 3

DR2

Vitamin D deficiency

Question 4

What is the most common form of MS?

Answer 4

Relapsing remitting

Question 5

What triad?

Answer 5

Dysarthria
Nystagmus
Intention tremor

Chariots neurlogical triad

Question 6

What sensory sign may be seen?

Answer 6

L’Hermittes sign

Question 7

What is the typical pattern of symptoms in MS?

Answer 7

Spaced out in time and space

Occur months and years apparent affecting different anatomical locations.