multiple sclerosis Flashcards
Information about MS.
risk factors for MS
age 30 female temperate areas certain viruses genetic low vitamin D levels while in womb
concordance of MS in identical twins
27%
pathology of MS
discrete plaques of demyelination at multiple CNS sites
how does MS develop?
unknown trigger –> T cell mediated response –> demyelination –> heals poorly –> relapsing/remitting –> progressive axonal loss
how is myelin damaged in MS?
auto-reactive T lymphocytes cross BBB and damage myeline and axons
what are active lesions in MS?
lots of cells migrate to cause damage
take up T1 and appear white on scans
how do chronic lesions appear on T1 scans in MS?
dark
signs of MS
unilateral optic neuritis (impaired vision and eye pain)
nystagmus
Brown-Sequard syndrome
Lhermite’s sign (flexion of neck causes shock down spine)
spasticity
symptoms of MS
visual disturbances numbness/tingling in limb leg weakness urinary and sexual dysfunction vertigo
What is Uhthoff’s phenomenon?
visual loss with increase in temperature
diagnosis of MS
clinical diagnosis
2 or more lesions disseminated in time and space
exclude all other conditions
MRI (sensitive but not specific) (leopard spots)
treatment of MS
stress-free life
vitamin D supplements
steroids - shortens acute relapses
interferons (e.g. betaferon) - decreases relapses and number of lesions
monoclonal antibody (e.g. alemtuzumab, nataluzimab, ocrelizumab) - acts against T cells
stem cell transplantation
rehab - physio etc…
bad prognostic indicators for MS
male
late age at onset
motor, cerebellar, and sphincter problems
