Neuro - Demyelinating Flashcards
what are the 3 clinical courses that MS can take?
relapsing and remitting
primary progressive
secondary progressive
risk factors for MS?
vit D deficiency higher latitude FHx smoking female
what are UMN signs?
spastic
hyperreflexia
weak upper extensors, weak lower flexors
increased tone
what happens in internuclear opthalmoplegia?
affected eye fails to adduct
other eye does so wih nystagmus
what happens in brown sequard?
hemisection of cord
what tracts are damaged in brown sequard? what does each do?
corticospinal = vibration, motor, deep touch
spinothalamic = pain, temp, crude touch
what are the features of brown sequard?
loss of spinothalamic on opposite side
loss of corticospinal on same side
what is lhermitte’s sign?
electric shock down back with neck flexion
what is uhtoff’s phenomenon?
old neuro symptoms flare up again when patient gets hot e.g in the back
how can MS present?
optic neuritis UMN signs cerebellar signs pain numbness bowel/bladder changes
Ix for MS?
clinical
MRI
LP (oligoclonal bands)
what criteria is used to diagnose MS?
mcdonald criteria
attacks disseminated in time and space
Tx for MS?
pred 500mg for 5 days acutely
interferon (IM)
fingolomod (risk of PML due to JC virus)
biologicals (risk of PML again)
baclofen gabapentin modafanil (fatigue) oxybutynin (bladder) anti depressants
what is guillan barre?
acute inflammatory demyelinating polyneuropathy
features of guillan barre?
progressive proximal muscles lost speech problems parasthesia hyporeflexia speech problems
