neuroimmunology Flashcards
what is the treatment of choice in optic neuritis?
IV steroids followed by oral taper. Quickens recover but does not affect long term outcome.
what percentage of adults with optic neuritis go on to develop MS over a 15 year period?
50%
in patients with acute ON and signs of other demyelinating brain lesions, what is the chance of developing MS over the next 5 years?
80%. Therefore initiating DMT is recommended.
what CSF finding is not expected in MS, but can be seen in neuromyelitis optica?
mild pleocytosis with neutrophil predominance.
what is the mechanism of action of natiluzimab (tysabri)?
prevents lymphocyte adherence to endothelial cells and so prevents their entry into the CNS.
what is the risk of developing PML on natiluzimab?
1:1000
what is the risk of anaphylaxis with natiluzimab?
1:50. Note, this is an absolute contraindication to giving any more drug.
what is the acute treatment of PML in patients taking natiluzimab?
plasmapharesis to remove the drug.
what is the mechanism of action of fingolimide?
modulates 4/5 of the sphingosine-1 phosphate receptors on thymocytes and lymphocytes and prevents lymphocyte egress from the lymph nodes.
what is the mechanism of action of Dalfampridine?
inhibits voltage sensitive potasium channels and increases nerve conduction in demyelinated nerve fibers. Improves walking speed in MS.
what is the mechanism of action of Cladribine?
Purine nucleoside analogue, interferes with proliferation of wbcs.
