Multiple Sclerosis Flashcards
what is multiple sclerosis
demyelinating disease of the CNS and axonal loss
what are the types of MS
remitting-relapse; clinical attacks of demyelination but in between the attacks, the patient is completely recovered
primary progressive MS; steady accumulation of disability
what is the most common form of MS
remitting-relapse
causes of MS
autoimmune basis with potential environmental trigger in genetically susceptible individuals
Immune-mediated damage to myelin sheaths results in impaired axonal conduction
risk factors for MS
vitamin D deficiency,
epstein barr virus
autoimmunity
between what ages does MS mainly present
more common in females
age of presentation; 20-40yrs
presenting symptoms of MS
optic neuritis (loss of central vision and pain of eyes on movement)
sensory (pins and needles, numbness)
motor (foot dragging, leg cramping, spasms, stiffness (Hypertonia), heaviness)
autonomic (urinary incontinence)
fatigue, hypertonia, hyperreflexia, impaired balance
investigations
diagnosis made upon 2 or more CNS lesions that correlate with the symptoms- this criteria is called McDonald criteria
you will also do a lumbar puncture and CSF analysis
what signs on physical examination may be present
Uhthoff’s Sign - worsening of neurological symptoms as the body gets overheated from hot weather, exercise, saunas, hot tubs etc.
Lhermitte’s Sign - an electrical sensation that runs down the back and into the limbs when the neck is flexed
what are the lesions called that will be seen in MS patients
paraventricular white matter lesions
what do you treat acute MS attack with
glucocorticoids- dexamethasone
chronic management of patients with MS
Symptomatic Therapy
Physiotherapy Baclofen and BoTox for spasticity Modafinil and exercise therapy for fatigue Anticholinergics for bladder dysfunction SSRIs for depression Sildenafil for erectile dysfunction Clonazepam for tremor
