Flashcards in MS Deck (83)
What are symptoms of Optic neuritis??
Pain in the right eye with blurred vision
Can lose complete vision in one of the eyes
What is optic neuritis?
Inflammation of the optic nerve
On examination what would identify on a patient with optic neuritis?
Reduced colour vision (Ishihara chart)
Reduced pupillary light responses (RAPD)
Hole in visual field (scotoma)
What is the prognosis of optic neuritis?
Good prognosis: 95% return to visual acuity of 6/12 or greater within 12 months
What is the treatment of optic neuritis?
High dose steroids speed up rate of recovery but have no effect on final acuity
Prednisolone is used
What percentage of people with optic neuritis will develop Ms?
50% go on to develop MS within 10 years
What is the role of MRI scan in optic neuritis?
Role of MRI tell you what type of optic neuritis it is and give some sort of insight whether or not it will lead to MS
What is transverse myelitis?
Inflammation inside the spinal chord
What is the prognosis of transverse myelitis?
Often mild with good prognosis
What is the symptoms of transverse myelitis?
Can get complains of tingly numbness starting in both feet and gradually ascending to level around chest
Lhermittes phenomenon--> is an electrical sensation that runs down the back and into the limbs which occurs when bending the head forward
What can be a complication of transverse myelitis?
May affect the bladder
What type of sensation is lost in transverse myelitis?
What is the percentage chance of developing Ms if you have transverse myelitis?
50% go on to develop Multiple Sclerosis
How do you diagnose Ms?
Having 2 different diseases such as optic neuritis and transverse myelitis at different times.
They cannot happen at the same time and the same disease cannot occur twice for it to be diagnosed as Ms.
What is the treatment for Transverse myelitis?
Treated with intravenous methylprednisolone 1g daily for 3 days
What is Ms?
MS is a disease of the central nervous system (CNS)
What is the mechanism in causing MS?
An inflammatory reaction in the CNS causes loss of myelin and slowing of nerve conduction
Areas of demyelination
Loss of axons
How common is MS in the UK?
It is the most common cause of neurological disability in young adults in the uk
Is MS more common in males or ladies?
What is the age of onset of MS and ethnicitiy suscepitbility?
Age of onest is 30-40yrs
Northern Europeans, US caucasians and Canadians are at high risk while African blacks and orientals are at low risk.
What is the epidemiology and latitude effect on MS?
Prevelance strongle dependent on latitude
Environmental factors such as habitat, diet and infections also have a part to play
What is action of lymphocytes in MS?
The CD4 T lymphocytes release a large amount of cytokines that cuase activation of immune system which leads to a problem in myelnation
What occurs in terms of myelination during MS?
There is demyelination as the immune system damages the oligodendryocytes that are invovled in the process of myelination.
There is also damage to the meylination and therefore diffuclt for the process of signaling
What is the main treatment for MS?
Interferon beta 1-b
What is the aim of treatments for MS?
Not a cure but try to prevent a relapse as every time you have a relapse the disability increases
What is the effectivness of inferferon beta drug work on preventing MS?
Reduces the number of relapses by a third
Effective early in the disease course
No evidence on long-term effect on disability
What is the site of infection, frequency and side effects of Betaferon 1b?
Flu- like symtpoms
Injection sight reactions
What is the site of infection, frequency and side effects of Avonex 1a?
What is the site of infection, frequency and side effects of Rebif 1a?