Multiple Sclerosis Flashcards
What is multiple sclerosis?
Chronic cell-mediated autoimmune disorder characterised by demyelination in the central nervous system
What is the epidemiology of multiple sclerosis?
- 3 x more common in women
* commonly diagnosed in people aged 30-40
What are the subtypes of multiple sclerosis?
- Relapsing-remitting disease
- Secondary progressive disease
- Primary progressive disease
How is a diagnosis of MS made?
- Basis of two or more relapses and either objective clinical evidence of 2 or more lesions or objective clinical evidence of one lesion with reasonable history
- Evidence of lesion from MRI
What is the presentation of MS?
Visual signs:
>Optic neuritis
>Optic atrophy
Sensory:
>Pins/needles
>numbness
>trigeminal neuralgia
Motor:
>Spastic weakness (legs)
Cerebellar:
>Ataxia
>Tremor
Other
>Urinary incontinence
>Sexual dysfunction
>intellectual deterioration
What is relapsing-remitting MS?
- Acute attacks lasting 1-2months followed by periods of remission
- most common (85%)
What is secondary progressive disease?
*Relapsing-remitting patients who have deteriorated and developed neurological signs and symptoms between relapses
What is primary progressive disease?
*Progressive deterioration from onset from onset
What is used to investigate MS?
- MRI
- SF
- Visual evoked potentials
What is the management of acute relapse of MS?
High dose steroids (oral or IV methylprednisolone) given for 5 days
What disease modifying drugs are used in MS?
*Beta-interferon (used to reduce relapse)
What is used to treat spasticity in MS?
- Baclofen and gabapentin first line
* Physio
What is used to treat bladder dysfunction in MS?
- USS first
- Significant residual volume = intermittent self-catheterisation
- No residual volume =anticholinergics to improve urinary frequency
