3: Multiple sclerosis Flashcards Preview

Neurology Week 4 2018/19 > 3: Multiple sclerosis > Flashcards

Flashcards in 3: Multiple sclerosis Deck (37)
Loading flashcards...
1

What is multiple sclerosis?

Inflammatory demyelinating disease of the CNS

2

Multiple sclerosis is more common in (men / women).

women

3:1

3

At what age do people tend to develop multiple sclerosis?

30s - 40s

4

Multiple sclerosis is an ___ disease.

autoimmune

5

What does "disseminated in time and place" mean in relation to multiple sclerosis?

Lesions have to have developed 

in different areas of the CNS

at different times

6

What is pyramidal dysfunction?

Problems affecting the pyramidal tracts i.e the corticospinal tract and corticobulbar tract

7

What do the

a) corticospinal tract

b) corticobulbar tract

control?

a) Voluntary movement

b) Movement re: cranial nerves

8

Pyramidal dysfunction causes (motor / sensory) symptoms.

motor symptoms

9

What are some examples of pyramidal dysfunction caused by multiple sclerosis?

Increased muscle tone

Muscle spasm

Weakness

Tremor

10

What is optic neuritis?

Inflammation of the optic nerve

11

What eye problems are caused by multiple sclerosis?

Optic neuritis (inflammation of optic nerve)

Nystagmus

Diplopia

12

What is the main complaint of optic neuritis?

Painful visual loss

13

What sign will you see on examination of the eyes of a patient with optic neuritis?

Relative afferent pupillary defect

swinging light test

14

What sensory symptoms do patients with multiple sclerosis complain of?

Pain

Tingling (paraesthesia)

Numbness

15

People with multiple sclerosis may lose their sense of proprioception and vibration.

Which sensory pathway is responsible for these?

DC/ML pathway

16

Which nerve is affected if a patient with MS complains of facial pain?

Trigeminal nerve (CN V)

17

Which part of the brain, controlling coordination, is affected in MS?

Cerebellum

18

MS causes cerebellar symptoms.

What is Charcot's triad of MS?

Dysarthria (slurred speech)

Tremor

Nystagmus

19

Which cranial nerves are affected if an MS patient complains of

a) diplopia

b) facial weakness?

a) CN III, IV or VI

b) CN VII

20

Patients with MS will complain of constant ___.

fatigue

21

Which investigations are used to diagnose MS?

Neuro exam

MRI scan (to pick up lesions)

Lumbar puncture (to examine CSF)

Blood tests (for autoantibodies and to rule out other diseases)

22

What are the Mcdonald criteria for diagnosing MS?

TWO episodes of symptoms suggesting demyelination

"Dissemination in time and place"

23

Why is the CSF examined in patients with suspected MS?

'Oligoclonal bands' in the CSF is highly predictive of MS

24

MS can ___ causing acute exacerbations.

flare

25

How are mild exacerbations of MS treated?

Symptomatic treatment

---

Baclofen and physio referral for motor symptoms

Gabapentin and amitriptyline for neuropathic pain

26

Why aren't normal analgesics e.g paracetamol used in the symptom management of MS?

Not effective for neuropathic pain

27

How are moderate exacerbations of MS treated?

Oral steroids

Immunosuppressant remember

28

How are severe exacerbations of MS treated?

Admission to hospital

IV steroids

29

Which anti-spasmodic drug is used to relieve motor symptoms of MS?

Baclofen

30

Which AHPs are involved in the management of motor symptoms of MS?

Physiotherapist

Occupational therapist