Demyelinating Diseases Flashcards Preview

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Flashcards in Demyelinating Diseases Deck (23):
1

What is MS

Chronic inflammatory disease of the CNS, Brain and Spinal Cord

- Myelin is destroyed and underlying neurons and axons are then destroyed as well

2

WHat is the pathologic lesion in MS

MS plaques- These occur when myelin is lost and inflammation and scar tissue build up

3

Most common form of MS is

relapsing remitting- pts develop periodic loss of neurological function

4

Uhtoff's phenomena

MS symptoms that worsen during and increase in body temperature....occurs because of poor electrical conduction along demyelinating axons

5

Define relapse

A new neurological disability that lasts at least 24 hours. Differentiated from stroke because relapse is subacute whereas stroke is acute

6

MS plaques visualized on MRI?

Yes

7

Spinal Fluid Profile of an MS patient?

IgG index elevated and oligoclonal bands (also present in infection of CSF) present

8

Significance of "gadolinium enhancing MS plaque"

Gadolinium does not normally enter the brain parenchyma. In situations where there is active inflammation and breakdown of the blood brain barrier, gadolinium is allowed to enter

9

MS plaques are ......... in nature

periventricular ( around a ventricle) and present in the deep white matter often adjacent to regions of cortical grey matter (juxtacortical)

10

What do you use to stain myelin

Luxol fast blue stain

11

At the edge of the plaque is a large inflammatory response made up of

- monocytes
- T and B cells
- Macrophages and microglia

12

MS typically diagnosed in what age range

20-40, usually women

The gender ratio in primary progressive form is about equal

13

Two most common types of MS

relapsing
progressive

14

Median time to reach moderate disability with relapsing mS

15 years

46 years to severe disability

15

How is MS diagnosed

- MRI
- Spinal tap
- Evoked potentials (measures brain's response to visual, auditory, and sensory stimuli)

16

Most common symptoms of MS

- Optic Neuritis- vision loss, central scotoma
- Myelitis- sensory symptoms in arms and legs as well as motor deficit
- Brainstem
- Cerebellum

17

Know that MS plaques are

periventricular

18

If the optic nerve is demyelinated there will be delay of the Visual Evoked Response, P100

KNOW

k

19

What is a Clinically Isolated Syndrome

A clinical episode suggestive of an MS patients first relapse

Things often affected

20

Transverse Myelitis

Acute neurologic condition that reflects focal inflammation of the spinal cord

- Acute or subacutely dveloping motor, sensory, shincter dysfunction

- Segmental layer of sensory disturbance with a well defined upper limit

No evidence of spinal cord compression...absence of other known neuro disease

21

Look At NMO

ok

22

Afferent pupillary defects seen in MS

yes. This is consistent with demyelination and axon damage

23

What are your chances of developing MS after an episode of transverse of myelitis

ok