MS Flashcards
What is Multiple Sclerosis (MS)?
autoimmune disorder causing demyelination in the central nervous system.
Usual demographic of patient with MS
Female
aged 20-40y (most common)
more common at higher latitudes
Name the MS subtype:
- most common form (85%) #
- acute attacks (last 1-2 months)
- followed by periods of remission
relapsing-remitting
Name the subtype:
- Relapsing-remitting patients who have deteriorated between relapses
- gait and bladder disorders are generally seen
Secondary Progressive
Name the subtype:
- 10% of patients
- progressive deterioration from onset
- more common in older people
Primary Progressive
What feature is required on imaging for a diagnosis of MS
demonstration of lesions disseminated in time and space
Signs on MRI
- high signal T2 lesions
- periventricular plaques
FLAIR images - hyperintense lesions penpendicular to the corpus callosum
Findings in CSF
oligoclonal bands
Treatment of MS acute relapse
High-dose steroids
- 5 days
Steroids only shorten the length of acute relapse. They do not improve function back to baseline. TRUE/FALSE?
TRUE
Indication for disease modifying drugs in MS
relapsing-remitting disease + 2 relapses in past 2 years + able to walk 100m unaided
secondary progressive disease + 2 relapses in past 2 years + able to walk 10m (aided or unaided)
Give examples of Disease Modifying Drugs used in MS
natalizumab (IV)
ocrelizumab (IV)
fingolimod (oral)
Beta interferon (S/C, IM)
glatiramer acetate (S/C)
Natalizumab target
alpha-4 beta-1-integrin
Ocrelizumab target
humanized anti-CD20 monoclonal antibody
Fingolimod target
sphingosine 1-phosphate (S1P) receptor modulator
