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Neuro week 3 > Multiple Sclerosis > Flashcards

Multiple Sclerosis Flashcards

1
Q

Is MS an issue with the CNS or PNS?

A

CNS

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2
Q

What is MS?

A

An inflammatory demyelinating disorder in the CNS

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3
Q

Where in the world is MS most common?

A

The further north (e.g. Scandinavia) or south (e.g. Tanzania) you go from the equator

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4
Q

What are the three types of MS course?

A

Relapsing remitting MS (RRMS) - 85-90%
- Secondary progressive MS (SPMS) - (20-50% of RRMS patients develop this)
Primary progressive MS (PPMS) - 10-15%

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5
Q

Are females or males more likely to have MS?

A

Females
F3:1

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6
Q

How does MS effect the pyramidal (corticospinal) tract?

A
  • Increased tone
  • Spasticity
  • Weakness
  • Effects extensors of upper limb
  • Effects flexors of lower limbs
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7
Q

How long does optic neuritis last in MS?

A

1-2 weeks

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8
Q

What sensory symptoms do you get in MS?

A

Pain
Paresthesia
Dorsal column loss (proprioception & Vibration)
Numbness
Trigeminal neuralgia

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9
Q

Symptoms of MS related cerebellar dysfunction

A

Dysarthria
Ataxia
Nystagmus
Intention Tremor
Past pointing
Dysdiadokinesis
Pendular reflexes

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10
Q

What are the symptoms of brain stem dysfunction in MS?

A

Diplopia (R VI palsy)
Facial weakness (R VII palsy)

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11
Q

Does MS effect the urinary tract?

A

yes

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12
Q

Is fatigue common in MS?

A

yes

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13
Q

What investigations can be done in MS?

A

Blood tests
MRI
CSF

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14
Q

What are we looking for in CSF for a positive result for MS?

A

presence of oligoclonal bands

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15
Q

What treatment is given for a mild relapse in MS?

A

Symptomatic treatment

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16
Q

What treatment is given for a moderate relapse in MS?

A

500mg oral steroids

17
Q

What treatment is given for a severe relapse in MS?

A

Admit + 1000mg IV steroid

18
Q

What medications are commonly given to treat spasticity in MS?

A

Baclofen, tizanidine

19
Q

What medications are commonly given for sensory symptoms in MS?

A

Anti-convulsant (i.e. gabapentin)
Anti-depressant (i.e. amitryptiline)

20
Q

How are lower urinary tract symptoms managed in MS?

A

Bladder drill
Anti-cholinergic (e.g. oxybutynin)
Desmopressin
Catheter

21
Q

How is fatigue managed in MS?

A

Amantadine
Hyperbaric oxgen

22
Q

What is first line therapy in MS?

A

Tecfedira, Aubagio
Interferon beta
Glitiramer acetate

23
Q

What is second line therapy in MS?

A
  • Fingolimod, Cladrabine
  • Monoclonal antibody - Tysabri, Ocrevus, Lemtrada
24
Q

What is first line in RRMS?

A

Tecfidera

25
Q

When are monoclonal antibodies indicated for treatment in MS?

A

In highly active RRMS after a previous therapy (tecfidera) has been tried

26
Q

How does spasticity effect reflexes?

A

More brisk reflexes

27
Q

What does a lower limb pattern of weakness look like in the lower limb?

A

Reduced hip, knee & plantar flexion

Neuro week 3 (8 decks)

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