MS Flashcards
One of the clinical presentations of MS is optic neuritis. What is optic neuritis
inflammation of optic vision
causes pain and loss of vision
does optic neuritis have a good prognosis
Yes
what drug is used to treat optic neuritis
steroid- predenisole.
what percentage of those who have optic neuritis develop MS within 10 years and what will be seen on a brain scan
50%
2-3 leisons
transverse myelitis is one of the clinical presentations of MS what is it
shows inflammation of the spinal cord
how do patients with optic neuritis present
pain and blurred vision
what investigations are used to determine where a patient has optic neuritis or not
Reduced colour vision (Ishihara chart),
Reduced pupillary light response (no constriction) (RAPD),
Hole in visual field (scotoma)- due to enlarged blind spot.
Fundoscopy- used to see if there is anything behind the eye, which may be causing the symptoms- everything, was normal.
does optic neuritis have a good prognosis
Yes
does transverse myelitis have a good prognosis
Yes
define Lhermites phenomenon.
shock like sensation from the midline at the neck down the arms.
how to patients with transverse myelitis present.
tingling numbness starting in both feet and ascending to the level of the chest “like a tight band”
Felt unsteady walking and fatigued easily.
Hyperreflexia.
Electric shock sensations running down the body whenever she bent her head
what investigations are used to diagnose MS
CT- shows inflammation of the spine.
how many people with transverse myelitis go on to develop MS
50% go on to develop multiple sclerosis
brain scan- 2-3 lesions
what is a key criteria for MS diagnosis
dissemination in time and place- 2 different parts of the body must be affected over a period of time
what are the symptoms of clinical definite MS
Optic neuritis and transverse myelitis at different times
what are the symptoms of non definite MS
Clinically isolated syndrome (CIS)
Myelitis and optic neuritis at the same time
Recurrent myelitis
Recurrent or sequential optic neuritis
why is a Lumbar puncture used to determine MS
– Check for OCB (oligo-clonal band) in CSF. These are immunoglobulins, which indicate inflammation in the CNS.
treatment for MS
intravenous methylprednisolone 1g daily for 3 days.
beta-interferon 1a injections- 5-10 year treatment with subcutaneous injections.
Is MS autoimmune
Yes
define MS
disease of the central nervous system.
inflammatory reaction in the CNS causes loss of myelin and slowing of nerve conduction- Areas of demyelination, loss of axons
which sex is MS more common in
females.
what is the pathogenesis of MS
both antibody and immune mediated.
Certain components of complement (e.g. lymphocytes), sit on the axon and breakdown myelin which slows down nerve transmission.
oligodendrocytes form myelin- destroyed by T cells.
how does interferon beta help is MS
reduced the number of relapses by 1/3.
what are the disease modyfying treatments of MS
- Interferon beta 1-b
- Interferon beta 1-a
- Glatiramer acetate
- Teriflunamide
- Dimethyl Fumarate
- Fingolimod
- Natalizumab (Tysabri)
- Alemtuzumab (Lemtrada)
- Mitoxantrone
