Neurodegenerative Disorders

Question 1

Multiple Sclerosis

Answer 1

Episodes of focal disorder of CNS
Demyelinating AND axonal disease
White matter predominant, some gray matter
Autoimmune

Question 2

Cause of MS

Answer 2

EBV titers present in almost all pts

EBV levels increased during acute MS attacks

Question 3

Genetic basis of MS

Answer 3

30% concordance in monozygotic twins
2-6% risk with full first degree relative
1.1-1.4% with half sibling

Question 4

Severity of MS

Answer 4

Intermediate 70-80%

Question 5

DX of MS

Answer 5

History
Neurological Exam
MRI ***
CSF studies
Evoked potentials

Question 6

CSF Study for MS

Answer 6

Best tool
Pleocytosis of <50 wbc
Non-specific protein elevation
High IgG synthesis rate
Presence of oligoclonal IgG bands

Question 7

TX of MS

Answer 7

Symptomatic
Exacerbation
Disease directed therapy

Question 8

ALS

Answer 8

Rare degenerative motor neuron disease
Characterized by insidious/progressive weakness, fasiculations, respiratory complications
80% mortality at 5 years

Question 9

DX of ALS

Answer 9

Exam finding of UMN/LMN dysfunction
EMG/NCS
MRI C-spine
Labs

Question 10

Weakness, vision disturbance, sensory disturbance CC

Answer 10

MS

Question 11

Weakness CC

Answer 11

ALS