Week 10 - Multiple Sclerosis Flashcards
what is multiple sclerosis
- autoimmune & chronic disorder that damages the myelin sheath of neurons
- causing a variety of sensory, motor, and cognitive deficits
what is the hallmark of MS
- presence of multifocal regions of myelin destruction (demyelination) & sclerosis of white matter in the brain, spinal cord, and/or optic nerve
- causes multiple sclerotic plaques (scar tissue) throughout the CNS
what is the cause of MS
- unknown
- thought to be autoimmune or due to an immune attack on virally infected oligodendrocytes
what are risk factors for MS (9)
- female
- age 20-40
- colder climate
- vitamin D deficiency
- european descent
- family history
- genetic risk
- smoking
- obesity
describe the sex risk factor of MS
- twice as common in women than men
why is a coler climate a risk factor for MS
- less sun exposure = lower vitamin D lvls
at what age do symptoms of MS occur
- between ages 20-40
describe the family history risk factor of MS
- risk of developing MS if 15x greater in individuals who have an affected first-degree relative
describe the genetic risk of MS
- genetic risk in individuals with certain MHC polymorphisms = supports autoimmune eitology
what does demyelination of neurons during MS cause
- slowed or blocked conduction = variety of neurological S+S
what do early lesions during MS occur as? what does it progress to?
- early lesions occur as small areas of inflammation which eventually remyelinate
- but eventually progress to firm demyelinated plaques, absent of oligodendrocytes (= no remyelination)
what are oligodendrocytes
- type of glial cell in the NS
- responsible for producing the myelin sheath
what pattern do symptoms of MS follow
- pattern of exacerbations & remission
what is a remission
- periods of recovery
what are periods of exacerbations
- flare ups or relapse
what are 3 triggers of MS
- stress
- infection
- fatigue
what causes remissions during MS
- if the initial inflammation subsides, neural function will return
- occurs with early lesions
what do multiple exacerbations cause
- over time, as oligodendrocytes die off, no longer get remyelination
- permanent loss of neural function
describe the symptoms of MS between individuals
- varies between affected individuals since location & severity of plaques is variable
what are common initial symptoms of MS (7)
- weakness
- numbness
- burning
- tingling
- unsteady limb
- visual disturbances
- sphincter dysfunction
at what point might symptoms of MS disapear
- after a few days to weeks, although examination shows a residual effect
what does a MRI of an individual w MS show
- presence of multiple lesions in the brain or spinal cord
what does analysis of CSF during MS show
- lymphocytosis
- elevated antibodies (indicate autoimmune)
what changes in mental status might you see during an assessment of MS (5)
- depression
- short term memory
- uncontrollable laughter & crying
- mood swings
- bipolar disorder
what changes in sensation might you see during an assessment of MS (7)
- numbness
- tingling
- burning
- itching
- “MS hug”
- nerve pain
- bladder dysfunction
what is a “MS hug”
- feels like a tight, painful hug
- feeling of tightness or pressure around the chest & stomach
what changes in movement might you see during an assessment of MS (9)
- dysphagia
- dysphasia
- dysarthria
- spasticity
- tremor
- weakness
- fatigue
- leg dragging
- weak resp. muscle
what changes in balance & coordination might you see during assessment of MS? (5)
- loss of balance
- ataxia
- unstable walking
- vertigo
- dizziness
what changes in reflexes might you see during assessment of MS
- positive babinski reflex
what nerves might MS effect (4 groups, 8 in total)
- CN2
- CN 3,4,6
- CN 8
- CN 9, 10, 12
