MS Flashcards
(38 cards)
What is the primary pathology of MS?
Multiple focal sites of demyelination in the CNS
What is the cause of demyelination in MS?
T-cell mediated immune response
What is the trigger of the immune response that causes MS?
Currently unknown
Does the demyelination of MS ever heal?
Yes, but not permanently
What is the typical temporal pattern of MS?
Relapse and remission
Remissions end up getting less and less complete however in progressing disease
Where in the world have the highest rates of MS?
Temperate areas
England, Scotland
T/F MS is more common in blacks/asians
F
Rarer in blacks and asians
If a person lives in a geographical area that has a high risk of MS, then moves to a low risk area and has children, what happens to the risk profile of them and their children?
Their risk will remain high because you take your risk of MS with you
Children acquire the risk of where they settle, so their risk would be low
If a person lives in a geographical area that has a high risk of MS, then moves to a low risk area and has children, what happens to the risk profile of them and their children?
Their risk will remain high because you take your risk of MS with you
Children acquire the risk of where they settle, so their risk would be low
What is the average age of onset of MS?
30 years old
Is MS more common in males or females?
Females
3:1
What role does Vit D seem to play in MS?
Circulating Vit D status relates to improved symptoms and prevention of MS
Early exposure to sunlight/vit D seems to be important, hence the geographical areas of high risk where sunlight exposure is low
What are some major sensory features of MS?
Dysaesthesia
Paraesthesia
Decreased vibration sense
Trigeminal neuralgia
What are some major motor features of MS?
Spastic weakness
Transverse myelitis (loss of motor, sensory, autonomic etc below the level of a lesion)
Does MS lead to erectile dysfunction?
Yes
As well as anorgasmia
Does MS lead to urine or faecal retention?
Yes
Urinary retention and constipation
What are some ophthalmological features of MS?
Optic neuritis
Diplopia
Pupillary defects
What are some cerebellar features of MS?
Trunk/limb ataxia
Intention tremor
Scanning (ie monotonous) speech
Falls
What are some major cognitive features of MS?
Decreased executive functioning
Decreased mood, depression and isolation
What conditions other than MS can cause hyperdense lesions in the CNS?
SLE
Sjogren syndrome
Polyarteritis nodosa
Syphilis
What conditions other than MS can cause hyperdense lesions in the CNS?
SLE
Sjogren syndrome
Polyarteritis nodosa
Syphilis
In what clinical situation would you almost not consider that something other than MS could be causing the symptoms?
young adult who has had two or more clinically distinct episodes of central nervous system dysfunction with at least partial resolution
Diagnostic difficulties arise in patients who have atypical presentations, monophasic episodes, or progressive illness
What are some clinical features that would make you begin to consider that the clinical syndrome was not MS?
Well demarcated spinal cord lesion level, below which are found all of the neurological symptoms
Patient is >60 or
What are some major DDx’s for MS?
Transverse myelitis
Neuromyelitis optica
Acute disseminated encephalomyelitis (ADEM)
