Multiple Sclerosis Vignette Flashcards
- Describe basic mechanisms of nerve conduction.
- Describe the consequences of demyelination in nerve conduction.
- Describe how certain therapies might improve nerve function.
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If administered a VER test (Visually Evoked Response) what 3 findings will be seen in patients with MS? What causes each of these findings (underlying pathology)?
1) Prolonged latency (demyelination)
2) Slower transmission (increased sodium entry)
3) Decreased amplitude (axonal loss)
Common symptoms of MS (8):
- Fatigue
- Walking impairment
- Spasticity
- Cognitive impairment
- Bladder dysfunction
- Pain
- Mood instability
- Sexual dysfunction
F:M RR for MS?
2.4:1
Prevalence?
100/100,000 (1/1000)
10% patients have a first degree relative with MS. What is the RR?
RR 3% (CO RR is 0.07%)
What three factors combine present to develop MS?
- Genetic predisposition
- Environment
- Infection (Epstein-Barr)
Where does demyelination occur? (anatomical structure)
Along the veins. This is visible in the brain–lines perpendicular to the lateral ventricles are called Dawson’s ventricles)
Why can contrast MRI be used to image the brain in MS patients?
Blood-brain barrier is compromised.
Do cognitive tasks require more or fewer neurons in patients with MS? How can this be visualized?
More. fMRI
With treatment, can disease progression be affected? Does life expectancy change with an early MS diagnosis?
Yes, can slow disease progression by 80%. No change in life expectancy, although quality of life is severely affected.
With Increased Sodium Entry into the Cell, There is ___- of Nerve Conduction
Slowing
What drug is indicated to improve walking speed in patients with MS? What is the mode of action of this drug?
Dalfampridine. K+ channel blocker (enhances AP conduction)
