Multiple sclerosis Flashcards
PREGANANCY WITH MS
DECREASES RELAPSES BUT THEN INCREASES AFTER DELIVERY. NO CHANGE IN LONG TERM PROGNOSIS.
GENETIC FACTORS
MAJOR HISTOCOMPATIBILITY COMPLEX (MHC) HLA-DRB1 LOCUS
MOST COMMON PATTERN
RELAPSING- REMITTING
POOR PROGNOSIS FACTORS
PRIMARY PROGRESSIVE, OLDER, CEREBELLAR AND MOTOR SYMPTOMS AS PRESENTING SIGNS AND MALES, PRIMARY PROGRESSING PATTERN.
GOOD PROGNOSIS FACTORS
FEMALE, YOUNG, OPTIC NEURITIS AS PRESENTING FACTOR, LONG REMISSION
LHERMITTE’S SIGN
PASSIVE NECK FLEXION CAUSING AN ELECTRIC SHOCK SENSATION. MOST LIKELY RESULT FROM INCREASED SENSITIVITY OF THE MYELIN TO STRECTH. CLASSIC IN MS BUT NO PATHOGNOMONIC.
WHATS THE NAME OF THE CRITERIA TO DIAGNOSE MS
Mc DONALD CRITERIA. COMBINES CLINICAL AND MRI FINDINGS. IN GENERAL INCLUDES LESION SCATTERED IN TIME AND SPACE.
CSF IN MS
OLIGOCLONAL BANDS AND ABNORMAL IgG PRODUCTION
COMMON LOCATIONS FOR PLAQUES
PERIVENTRICULAR, CORPUS CALLOSUM, CENTRUM SEMIOVALE OR BASAL GANGLIA.
MORE SENSITIVE TEST
MRI
TREATMENT
- ACUTE ATTACKS
- DECREASE RELAPSES
- NATALIZUMAB COMPLICATION
- GAIT SPEED
- SPASTICITY
- ACUTE: FIRST LINE: CORTICOSTEROIDS (CEREBELLAR AND SENSORY SYMPTOMS DOES NOT RESPOND WELL). SECOND LINE: PLASMA EXCHANGE
- RELAPSES: IMMUNOMODULATORS. MOST OF THEM ALSO DECREASE MRI LESIONS.
- NATALIZUMAB: ASSOCIATED WITH PML
- GAIT SPEED: AMPYRA
- SPASTICITY: BACLOFEN
OPTIC NEURITIS VS INO
ON: DEMYELINATION OF OPTIC NERVE
INO: DEMYELINATION OF MLF
ISSUES ASSOCIATED WITH MS
DEPRESSION, INCREASED SUICIDAL RATE, DYSPHAGIA/DYSARTHRIA, DELAYED PROCESSING SPEED, COGNITIVE IMPAIRMENT CORRELATES WITH CORTICAL ATROPHY, DECREASED SHORT TERM MEMORY
