(PM3B) Multiple Sclerosis – MS Flashcards
What is multiple sclerosis?
Autoimmune disease of the central nervous system (brain + spinal cord)
Typically affects young adults
Onset between 20-40yrs old
What is the male to female ratio of multiple sclerosis incidence?
3:1
(was 2:1 in the 1950s)
What are some potential environmental risk factors for multiple sclerosis?
(1) Viral exposure – Epstein Barr Virus
(2) Tobacco exposure
(3) Obesity
(4) Sunlight – vitamin D
What are some potential genetic risk factors for multiple sclerosis?
(1) Close family members with the disease
(2) 1st degree relatives have 2.5-5% risk
(3) Identical twin has a 20-25% risk
(4) Specific immune-related genes
What are the different clinical presentations of multiple sclerosis?
(1) Relapsing
(2) Remitting
(3) Progressive
What is primary progressive multiple sclerosis?
Progressive multiple sclerosis from the start
~20% of MS patients
What is secondary progressive multiple sclerosis?
MS patients with relapsing/ remitting MS
Who go on to develop progressive
What is Uhthoff’s phenomenon?
Significant worsening of multiple sclerosis symptoms
In response to increase in temperature
e.g. immersion in hot bath
What is Lhermitte’s sign?
Electrical sensation running down the spine
Following neck flexion
Present in multiple sclerosis
What test can be used to help diagnose multiple sclerosis?
MRI
Detection of white matter abnormalities + spinal lesions
What is the McDonald diagnostic criteria?
Assessment of additional diagnostic data needed
Based on clinical presentation observed
Ho wis multiple sclerosis diagnosed?
(1) Abnormalities on MRI
(2) Time-course for clinical episodes
(3) Cerebrospinal fluid markers
Describe the pathology of multiple sclerosis?
(1) Inflammation of brain + spinal fluid
(2) Inflammatory molecules are primarily lymphocytes + macrophages
(3) Demyelination of neurones
(4) Leads to axonal damage + neuronal loss
(5) Initial cause of inflammation in multiple sclerosis is unclear
What does the pathology of multiple sclerosis cause?
(1) Acute loss of function
(2) Repairable damage
(3) Chronic damage
What is a major cause of irreversible deficit in multiple sclerosis?
Axon degeneration
How much of the spinal cord cross section can be lost annually in primary progressive multiple sclerosis?
~5%
What is the primary cause of a release of multiple sclerosis?
Conduction block
Due to demyelination + inflammation
What is the primary cause of remission of multiple sclerosis?
Restoration of conduction
Remyelination + decreased inflammation