Multiple Sclerosis Flashcards
Where is the prevalence of MS highest geographically?
Northern US, Canada, Northern Europe (highest in Scotland), Scandinavia, New Zealand, Australia
Where is the prevalence of MS medium geographically?
Some parts of Europe, Central and South America, Eastern Europe
Where is the prevalence of MS lowest geographically?
Low/probably low: Asia and Africa
The etiology of MS is…
Ultimately unknown
What is the leading theory behind the etiology of MS?
It is an autoimmune disease that occurs in genetically susceptible individuals that is triggered by a viral (or other) infection
What are common infections that can precipitate MS?
Herpes ( I, II, and VI) and Chlamydial Pneumonia
What are the initial symptoms for Corticospinal MS?
Spastic paralysis Stiffness Slowness Weakness Decreased endurance Symmetrical with LE affected greater than UE Incontinence of bowel and bladder
What are the initial symptoms for Brainstem MS?
UMN CN III-XII Internuclear opthalmoplegia (affected eye cannot adduct Nystagmus Dysarthria Vertigo Tinnitus Facial weakness Facial sensory loss
What are the initial symptoms for Cerebellar MS?
Ataxia (movement decomposition and dysdiadochokinesia)
Hypotonia
Paresis
Symmetrical in all 4 extremities
What are the initial symptoms for Cerebral MS?
Affected cerebral hemispheres Optic neuritis (CNII) Intellectual and/or emotional changes Seizures Hemiparesis Hemisensory loss
What is the often the initial presenting symptom of MS?
Optic neuritis
What is optic neuritis?
Inflammatory demyelination of the optic nerve (CNII)
What are the symptoms of optic neuritis?
Eye pain w/ movement (ice pick in eye)
Monocular vision problems
What are examples of monocular vision problems?
Central scotoma: “disappearing image”, missing image
Decreased visual acuity
Impaired color vision
What is the course of optic neuritis like?
Typically occurs as an acute event (days) or can progress slowly
What is the prognosis of optic neuritis?
Recovery is common and typically occurs within 6-8 weeks, although it may take several months
What are general common signs and symptoms of MS?
Visual Motor Sensory Bowel and Bladder Sexual Cognitive and emotional Speech and swallowing Pattern of symptoms
What is the most common “package” of symptoms of MS?
Balance Fatigue Gait Bladder/bowel Vision
What are the 4 different stages/groups of MS that represent its clinical course?
Clinically isolated syndrome (formerly called benign) Relapsing remitting (RRMS) Primary progressive (PPMS) Secondary progressive (SPMS)
What percentage of MS cases are Clinically isolated syndrome?
Less than 20%
What percentage of MS cases are relapsing remitting?
85%
What percentage of MS cases are primary progressive?
10% of cases
Majority of cases w/ RRMS progress to…
SPMS
What are the precipitating factors for MS?
Changes in health status
Transient deterioration
What are examples of changes in health status in MS that encompass its precipitating factors?
Viral or bacterial infections (Cold, flu, UTI)
Physical injury (Lumbar puncture)
Pregnancy/birth
What are examples of transient deterioration in MS that encompass its precipitating factors
Adverse reaction to heat: such as modalities, prolonged exercise, fever
Hyperventilation
Stress: Physiological or psychological (major and minor)
Exhaustion
Dehydration
Malnutrition
Sleep deprivation
___ of relapses are preceded by a viral infection
33%
