Multiple Sclerosis Flashcards
What kind of disease is multiple sclerosis?
Immunological / neurodegenerative disease
What happens with the immune system in those with MS?
Immune system attacks myelin sheath around brain, SC, optic nerve (demyelination)
Chronic inflammation / diffuse demyelination to white / gray matter and axons
Formation of plaques: Scar tissue formation that reduces impulse conductivity along axons
What is the cause of MS?
unknown
Hypothesis: genetics (polygenetic) + environmental factors like smoking, lack of ultraviolet light exposure results vitamin D deficiency
Viral infection: Mononucleosis; Epstein-Barr
MS is the most common what?
nontraumatic neurodegenerative disorder among people under age 40
Where is the world are people less likely to have MS?
living by equator
Which populations are more susceptible?
Affects females more
Scandinavian / Scottish descent more susceptible
2x more common among Caucasians
What is the most common complaint in those with MS?
fatigue
can be debilitating
What are some signs and symptoms of MS?
Fatigue
Motor, sensory, visual, and autonomic systems affected
Diplopia
Dysesthesia / paresthesia
Erectile dysfunction
Gross / fine motor incoordination
Cognitive deficits
Depression / euphoria
Loss of visual acuity
Spasticity
Dysphagia
Vestibular dysfunction
About 80% of people with MS have some loss of what?
Visual acuity: partial loss of vision, double vision, ocular pain
What age is the typical diagnosis?
btwn 20-40 years old
30yrs old peak onset
Not common to be diagnosed > 60 yrs old
What are the 4 patterns of MS?
Clinically isolated syndrome (CIS)
Relapsing-Remitting MS (RRMS)
Secondary Progressive MS (SPMS)
Primary Progressive MS (PPMS)
What is Clinically isolated syndrome (CIS)?
mildest form of MS
Refers to a 1st episode of neurologic symptoms that lasts at least 24 hrs and is caused by inflammation or demyelination
Can be either monofocal or multifocal
May or may not progress to MS
If accompanied by MRI findings, may be diagnosed as MS
Accurate diagnosis important so that disease-modifying therapy can be started to prevent onset of MS
What is Relapsing-Remitting MS (RRMS)?
Most common form
Clearly defined attacks of new or increasing neurologic symptoms
Relapses followed by periods of partial or complete remission
Active/ Not Active: relapses and/or evidence of new MRI activity
Worsening/ Not Worsening: Confirmed increase in disability over a specified period of time following a relapse
What is Secondary Progressive MS (SPMS)?
Most people with RRMS will eventually transition to SPMS
Progressive worsening of neurological function
Active/ Not Active
With Progression/Without Progression: Evidence of disease worsening on an objective measure of change over time (EDSS)
What is Primary Progressive MS (PPMS)?
Worsening neurologic function and accumulating disability w/o early relapses or remissions
Active/ Not Active
With Progression/ Without Progression
~15% of people w/ MS have PPMS
Less inflammation than other forms of MS
Fewer brain lesions (plaque)
More lesions in the spinal cord: most attacks are to spinal cod
More difficult to diagnose and treat than relapsing forms of MS- Diagnosis typically is 10 years later than RRMS
