Multiple Sclerosis Flashcards
What is it?
A cell mediated autoimmune condition causing repeated inflammation of the nervous tissue in the brain and spinal cord
What happens to the nerves?
They eventually lose their insulating myelin sheath layer, and multiple areas of scar tissue form called Sclerosis
What does this damage do?
It prevents the neuronal transmission to muscles and sense organs
What causes it?
The cause is not fully understood but is autoimmune with a suspected genetic component
What three types are there?
- Relapsing-Remitting (comes and goes)
- Secondary Progressive (gradually fewer remissions)
- Primary Progressive (symptoms get worse from the beginning)
Is it common?
285 per 100,000 women and 113 per 100,000 men per year in the UK
Who does it affect?
It is more common in women, peak onset is 40-50 years old and it is more common the further from the equator
Risk Factors (2)
family history, increased risk post-partum
Symptoms (13)
Usually monosymptomatic at first, Optic Neuritis (reduced central vision and pain), limb paraesthesia, leg weakness, diplopia, ataxia, trigeminal neuralgia, spastic muscles, erectile dysfunction, anorgasmia, burning, twisting, tightness
Differentials (2)
Hereditary Spastic Paraplegia, Sarcoidosis
What bloods would you do? (10)
FBC, ESR, CRP, U&E, LFT, TFT, Glucose, HIV Serology, Calcium, B12
Other investigations (3)
Electrophysiology studies, MRI, Cerebrospinal fluid serology for Oligoclonal bands of IgG
What is found in CSF?
Oligoclonal bands of IgG
What criteria is used for MS?
The McDonald Criteria
What is the treatment? (9)
Encourage stress free life, Vitamin D, Steroids, Interferons A and B, Monoclonal Antibodies e.g Rituximab, Azathioprine, Diazepam for Spasticity, Botox injections for tremor, Cannabinoids
