Neurological Disorders - Multiple Sclerosis Flashcards
What is targeted in the CNS in multiple sclerosis?
Myelin sheaths
What is the etiology of multiple sclerosis?
Unclear - autoimmunity Complex trait Familial tendency (15x inc) Viral trigger? - autoimmunity
What is the patho of multiple sclerosis?
Antibodies target myelin which leads to sclerotic patches (plaques) leading to inflammation and damage
Some oligodendrocytes are destroyed if the demyelination occurs in an area with oligodendrocytes
____ problems occur as a result of demyelination
Conduction
What varies based on where sclerosis occurs and location of targeting in multiple sclerosis?
Symptoms
Where are the most common areas of demyelination?
Optic nerve Peri ventricular region Cerebellum Spinal cord Brain stem
What infiltrate into plaques in MS? What about in acute inflm?
T lymphocytes and macrophages, in acute inflm neutrophils infiltrate too
Which neurons are affected in MS?
Motor and sensory neurons
What are manifestations of MS?
Visual impairment Parasthesias (abnormal sensation - tingling) Fatigue Bowel and bladder dysfunction Decreased muscle strength Gait and coordination problems
How is MS diagnosed?
History and clinical presentation
MRI to image plaques
Analyze CSF for proteins (specifically antibodies)
What are the three reasons why proteins may appear in the CSF?
Damage to the BBB
Autoimmunity
Inflammation
What is the treatment for ms?
Steroids to diminish exacerbation for acute relapses
Methotrexate (must give folate with medication as it is an antifolate)
Interferon ( for patient with persisten relapses)
Symptomatic treatment
What does chronic exacerbation and remission entail in ms?
A individual goes into remission and then the mnft come back worsened
Who does multiple sclerosis most commonly affect?
Young women 20-40 because of autoimmunity
