MS Flashcards
Definition of MS
Multifocal inflammatory disorder of CNS disseminated in space and time
Eye signs in MS
Nystagmus - towards lesion
Bilateral internuclear ophthalmaplegia
Optic atrophy + reduced visual acuity
RAPD
Internuclear ophthalmaplegia definition
ipsilateral weakness of adduction, nystagmus in contralateral eye
RAPD definition
Dilation of both eyes when light is shone into affected eye, normal accomodation reflex
Upper limb signs in MS
Pyramidal weakness w/ UMN signs
Cerebellar signs - DANISH + rebound phenomenon
Loss of dorsal column w/ pseudoathetosis
Pyramidal weakness (Upper limbs)
weak extensors, flexed arm with hyperreflexia and hypertonia
Dorsal column lesion
Loss of vibration sense and proprioception
Pseudoathetosis
Loss of proprioception causes writhing movements
Lower limb signs in MS
Pyramidal weakness
Ataxic gait due to cerebellar lesion
Impaired coordination
Investigations of MS
MRI head - hyperintense lesions in periventricular white matter
LP - Oligoclonal bands
VEP - Delayed velocity but normal amplitude
Management (Conservative) in MS
MDT approach - Neurologist, education + counselling, PT/OT - Walking aids + orthoses
Management (Acute) in MS
IV Methylprednisolone
Plasma exchange in steroid resistant patients
Different types of MS
Relapse remitting
Primary progressive - no relapses
Secondary progressive - some relapses then none
Progressive relapsing
Management (Prevention of relapses) in MS
Interferon Beta -> reduced relapse rate by 1/3
Natalizumab -> reduces relapse rate by 2/3
Baclofen - for spasticity
