[Neuro] Multiple Sclerosis Flashcards
what is multiple sclerosis (MS)?
most common immune-mediated demyelinating disease of the CNS
how many types of MS are there and what is the most common?
4 types; relapsing-remitting
what is the 1st line ix for MS?
MRI head / spine
how can a dx of MS be made?
neurological features and MRI findings disseminated in time and space
what are the radiological features in MS: white matter lesions?
in:
- periventricular (Dawson’s fingers)
- corpus callosum
- infratentorial region
what are the radiological features in MS: T2 weighted MRI?
hyperdense lesions
what are the radiological features in MS: T1 weighted MRI?
hypodense lesions
what is the main differential for MS?
neuromyelitis optica
what are the features of neuromyelitis optica?
- more severe inflammation, disability and mortality associated with relapses
- white matter of optic nerve / spinal cord involved
- anti-aquaporin channel 4 antibody +ve
what are the motor signs of MS?
- spasticity
- cerebellar ataxia
- UMN signs only
what are the visual signs of MS?
- optic neuritis
- bilateral internuclear ophthalmoplegia
- oscillopia
- RAPD
what are the specific signs in MS?
- Lhermitte’s syndrome
- Uhthoff’s phenomenon
what are other signs of MS?
- neuropathic pain
- cognitive decline
- emotional lability
- urinary urgency / incontinence
pt with MS has spasticity sx. what is the 1st line rx?
baclofen or gabapentin
what is spasticity in MS exacerbated by?
- constipation
- UTI / other infections
- pressure ulcers
- posture
