Week 11: Multiple Sclerosis Flashcards
1
Q
What is a scotoma?
A
hole in the visual field
2
Q
What is optic neuritis?
A
- inflammation of the optic nerve
- causes pain and loss of vision
- frequently not visible (retrobulbar)
- good prognsosi
- high dose steroids speeds up recovery but has no effect on final acuity so is not prescribed
- 50% go onto develop MS within 10 years
3
Q
What is transverse myelitis?
A
- inflammation inside the spinal cord
- often mild with good prognosis
- purely sensory
- Lhermittes phenomenon - get an electric shock when you bend your neck
- may affect bladder
- 50% caused by viruses
- 50% go onto develop multiple sclerosis
4
Q
How do we diagnose MS?
A
- 2 attacks
- must be disseminated in time and place
- macdonald criteria 2017
5
Q
What is clinically definite MS?
A
Optic neuritis and transverse myelitis at different times
6
Q
What is not definite MS?
A
- Clinically isolated syndrome (CIS)
- myelitis and optic neuritis at the same time
- recurrent myelitis
- recurrent or sequential (opposite eyes) optic neuritis
7
Q
What is MS?
A
- commonest cause of neurological disability in young adults in the UK
- disease of the CNS
- an inflammatory reaction in the CNS causes loss of myelin and slowing of nerve conduction
- areas of demyelination
- loss of axons
- immune system attacks myelin
8
Q
Who gets MS?
A
- 2:1 F:M
- 30-40 years is typically age of onset
- high risk in europeans
- typical epidemiology of an autoimmune disease
9
Q
What is the name of the first humanised monoclonal antibody approved for treatment of MS?
A
Tysabri
10
Q
What is natalizumab?
A
- antibody that attacks adhesion molecules of leukocytes
- reduction in relapse rate is 80% which is the best treatment available
- however if you have JC virus at the time of treatment, you can catch progressive multi focal leukoencephalopathy (PML)
11
Q
What are the types of disease progression for MS?
A
- Relapsing-remitting MS (most common)
- Primary progressive MS (10%)
- Secondary progressive MS (treatable, but not curable)
in most cases, there is a relapsing phase followed by a progressive phase
