Multiple Sclerosis Flashcards

1
Q

What is MS?
Where does it effect?
What 2 processes?

A

Acquired, chronic, immune-mediated inflammatory condition of the CNS

Brain, brainstem & spinal cord

Demyelination & gliosis

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2
Q

What is the mean age of onset?

What gender?

A

30 years

Female

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3
Q

What is the most common pattern of MS?

A

Relapsing-remitting (85%)

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4
Q

Describe RRMS

A

Relapses followed by remission and periods of stability

Symptoms may completely resolve in these times, but after several relapses there may be only partial recovery

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5
Q

What is Secondary progressive MS? (SPMS)

A

RRMS pattern at first, then the disease gradually worsens (with or without continued relapses)

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6
Q

After 6 years, what percentage of RRMS becomes SPMS?

A

About 25%

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7
Q

What is primary progressive MS? (PPMS)

A

Steady progression and worsening from onset

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8
Q

What is a relapse?

A

Onset of new symptoms/ worsening of current symptoms, lasting >24 hours
ABSENCE OF FEVER, INFECTION ETC

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9
Q

Give 4 risk factors for MS

A

FH
EBV
Smoking
Low vitamin D

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10
Q

What are the 4 most common presentations?

A

Optic neuritis
Transverse myelitis
Cerebellar
Brainstem syndromes

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11
Q

How does optic neuritis present?

A

Total unilateral visual loss over a few days

Pain behind the eye & on movement

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12
Q

What may be signs of optic neuritis on examination?

A

Reduced acuity
Scotoma
Reduced colour vision
RAPD

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13
Q

What is transverse myelitis?

A

Focal inflammation within the spinal cord

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14
Q

How does transverse myelitis present?

think sensory and motor

A

Sensory: paraesthesia

Motor: weakness below the level, ‘tight band sensation’

May be urinary symptoms

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15
Q

What are some cerebellar-related symptoms?

A

Ataxia, vertigo, clumsiness

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16
Q

What tests would you do in suspected cerebellar problems?

A

Finger-to-nose

Heal-to-toe walk

17
Q

How may brainstem syndromes present?

A

Ataxia
Eye movement abnormalities (diplopia, nystagmus)
Speech problems

18
Q

What is the MacDonald Criteria?

A

Method of diagnosing MS

E.g. >2 relapses/ initial episode where diagnosis not clear, may be said to have a CIS (clinically isolated syndrome), most will progress to MS

19
Q

How are relapses managed?

A

Steroids (methylprednisolone)

20
Q

How else can symptoms be managed?

A

Physiotherapy

Cognitive rehabilitation