Quiz 8 - MS, demyelination Flashcards
gender ratio of MS
2/3 are female
MS predisposition
HLA DR2
types of MS
1) relapsing-remitting
2) secondarily progressive - more aggressive, faster decline, less remission
3) primary progressive - no episodes, no sudden onset, diagnosed during illness with MRI
4) progressive relapsing - mix of decline with occasional episodes
what is an exacerbation/attack?
- neurologic disturbance
- lasts longer than 24 hours
- at least 30 days between attacks (shorter is just the same attack waxing and waning)
pathophysiology of MS attack
- Th cells activated for unknown reason
- attracted to vessels of BBB
- breakdown of BBB
- Th cells reencounter antigens in CNS
- attack CNS myelin
sensory symptoms of MS
- numbness/paresthesias
- can be poorly localized
- unilateral or bilateral
vision in MS
- optic neuritis very common
- double vision
motor problems in MS
- ataxia
- dysmetria
- hemiparesis possible
- bladder/bowel
- sexual dysfunction
MS symptoms increased by
overheating
easiest and hardest types of MS to diagnose
easiest - relapsing-remitting (most common)
hardest - primary progressive
classical definition of MS
multiple white matter lesions separated in space and time
is there a biological test for MS?
no
definitions of space and time
time - at least 30 days between clear symptoms
space - at least two anatomic events confirmed by imagery
diagnostic criteria for MS
- objective abnormalities of CNS
- white matter involvement predominant
- at least two lesions
- 2 or more events over 6 months
- no other disease explains it
diagnostic categories of MS
- at risk - all criteria are met except
has only been one episode and one finding on exam
no clinically isolated syndrome - probably MS - all criteria are met except
missing one event or one exam finding - clinically defined - all criteria are met
