Clinical Approach to Multiple Sclerosis

Question 1

What is the cause of symptoms in Multiple Sclerosis?

Answer 1

They are a result of a loss of nerve tract insulation (myelin) at multiple sites in the CNS

Question 2

What are common neurologic symptoms of M.S.?

Answer 2

• Parasthesias
• Gait disturbance (transverse myelitis)
• Weakness
• Visual loss (optic neuritis)
• Urinary difficulty
• Dysarthria
• Hemiparesis

Question 3

Most patients have which type of M.S?

Answer 3

Relapsing remitting

Question 4

Geographically, which patients are less likely to be at risk for developing M.S?

Answer 4

those who live closer to the equator

Question 5

What studies are used to make the diagnosis of MS?

Answer 5

• MRI of the head, C spine, T spine
• Multimodality evoked potentials
• LP for CSF analysis

Question 6

What would you expect to see in a Lumbar CSF analysis of a patient with MS?

Answer 6

Presence of oligoclonal bands and/or increased IgG index/synthesis rate

Question 7

What is the “classic” definition of MS?

Answer 7

MS is diagnosed by multiple lesions over space and time

Question 8

What is the goal of the drugs used to treat MS?

Answer 8

to slow the progression of the disease

used for “maintenance” (to decrease the frequency and severity of exacerbations of the disease)

Question 9

What are the disease-modifying drugs used for MS?

Answer 9

• Interferon Beta
• Glatirimer Acetate
• dimethyl fumarate
• anything that ends in “-mab”
• anything that ends in “-mod”

she says to just learn these. no need to memorize specific drug names

Question 10

Which drug is approved for the primary progressive form of MS?

What form are most medications used for?

Answer 10

Ocrevus is the only drug approved for PPMS

Most drugs are used for patients with relapsing forms of MS