Multiple Sclerosis

Question 1

List the Determinants of MS

Answer 1

Epstein-Barr Virus
Latitude - further away from the equator = more at risk
Obesity/ Increase in BMI
History of smoking

Genetics
Ethnicity - Pakhea more likely
Sex - Females more likely

Question 2

Aetiology of MS

Answer 2

Cause is unknown

Auto-immune disease where the host’s immune system attacks it’s own body (oligodendrocytes - CNS myelin)

Question 3

Pathophysiology of MS

Answer 3

Demyelination: Autoimmune response –> inflam. and scarring across multiple areas of the oligodendrocytes (CNS myelin)

Damage occurs to myelin and neurons –> interferes with the transmission of signals

Patches of inflam./symptoms resolve (seen in 1 type of MS)

Patches of inflam. don’t heal –> symptoms progress

Question 4

Clinical Feats. of MS (in terms of Comparator)

Answer 4

Ataxia - difficulty coordinating movements

• gait, balance and smooth movement problems
• coordinating eye movement problem
• coordinating speaking muscle problems
• dizziness

Question 5

Clinical Feats. of MS (in terms of Corrector)

Answer 5

Difficulty learning motor tasks (procedural learning)

• Problems with re-learning a movement
• Problems learning a new movement/skill
• Problems adapting to new situations

Question 6

Progression of MS (3)

Answer 6

1. Relapsing Remitting MS:
   - most common (85%)
   - Acute attack with full or partial recovery of symptoms
   - Periods of attacks due to lack of progression of MS
2. Secondary Progressive MS:
   - Starts as Relapsing Remitting MS but then has less recovery after an attack
   - Worsened function during and between attacks
   - Fewer attacks but it increases disability
3. Primary Progressive MS:
   - less common
   - Progression of disability without remission
   - NO acute attacks