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Flashcards in Autoimmune Deck (14):
1

MS causes

mostly environmental?
possible viral infection in childhood
possibly vitamin D deficiency
small genetic risk

2

Diagnosing MS

clinical diagnosis
clinical evidence of lesions of CNS that are disseminated in time and space (>=2 different regions in central white matter affected at differnet times)

3

MS imaging

MRI:
T1 weighted (fat is bright): hypointense black holes = areas of permanent axonal damage
T2 bright areas = demyelinated plaques located in white matter

4

MS Labs

oligoclonal bands in CSF
synthesis of homogenous Ig by individual plasma cell clones in CSF
sens 80%, spec 92%

5

Pathophysiology of Relapsing-remitting MS

MS lesions: majority located in white area near cerebellum, spinal cord, brainstem and optic nerve
conduction block, demyelinating

Remyelinating:
- occurs at early stages of disaease
- slow; repeated attacks lead to fewer successful remyelinations
- lesion become irreversible

Inflammation:
- T-cell mediated; infiltrate into brain via BBB
- attack myelin

6

Course and prognosis of MS

INO
Lhermitte's symptom
Uhthoff's phenomenon
Ephatic transmission

7

Lhermitte's symptom

electrical sensation that runs down back into limbss when flexing neck
lesion of dorsal columns of cervical cord/caudal medulla

8

Uhthoff's phenomenon

increased symptoms due to heat
altering conduction of nerves

9

Ephatic transmission

tramission of charge between neighbouring axons --> paroxysmal symptoms

10

Types of MS

Relapsing/remitting
secondary progerssive
primary progressive
progressive/relapsing MS

11

MS relapse management

corticosteroids
rehab

12

MS disease-modifying therapies

prevent disability; can help reduce relapse rates
beta-interferons

13

MS chronic symptom management

spasticity: baclofen/tizanidine
bladder: self-catheterization
pain, erectile impotence, fatigue, depression

14

Romberg test

positive:
ataxia is sensory in nature; depending on loss of proprioception
affected PCML/peripheral sensory neurons
NOT a test of cerebellar function