Multiple Sclerosis Flashcards
What is multiple sclerosis (MS) defined as?
inflammatory demyelinating disorder the central nervous system (brain and spinal cord)
What name is given to the specific areas of inflammation in MS ?
Plaques
Plaques are disseminated in time and space. What does this mean?
Plaques appear in different places at different times
Describe the Female:Male ratio of MS
3:1
When are most initial presentations of MS?
30s-40s
How is MS thought to be distributed geographically?
Further from equator = higher risk of MS
Also countries with low Vitamin D levels shower higher rates of MS
What type of course can a patient’s MS take after their diagnosis?
1) Relapsing and Remitting Course
2) Secondary progressive (starts like number 1 but can progress)
3) Progressive Relapse (No. 1 but always progressing)
4) Primary progressive
What are the main clinical features of MS?
- Pyramidal dysfunction
- Optic neuritis
- Sensory symptoms
- Lower urinary tract dysfunction
- Cerebellar and brain stem features
What is meant by pyramidal dysfunction?
- Increased tone => increased reflexes also
- Spasticity
Weakness in: - Extensors of upper limbs
- Flexors of lower limbs
What is an optic neuritis and how many MS patients have this as their initial presentation?
- Painful visual loss lasting 1-2 weeks (due to inflammation of nerves around eye)
- Most of these improve
- around 1/2 of MS patients initially present with ON
What sensory symptoms may a patient with MS experience?
- pain
- Paraesthesia “burning” or “water running down leg”
- Loss of Proprioception and vibration
- Numbness
- trigeminal neuralgia
What symptoms may indicate a patient has cerebellar dysfunction due to MS?
Ataxia Intention Tremor Nystagmus Dysdiadokinesis (cant perform rapid alternating movements) Dysarthria
What symptoms can indicate brainstem dysfunction in MS patients?
Diplopia (CN VI palsy) Facial weakness (CN VII palsy)
What is internuclear ophthalmoplegia?
Inability to coordinate both eyes moving at same time
Failure of adduction in affected eye
=> it lags behind and causes a diplopia
Nystagmus is seen in abducting eye whilst lagging eye is catcing up
What symptoms indicate lower urinary tract dysfunction?
- frequency
- nocturia
- urgency
- urge incontinence
- retention