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Flashcards in MS and ALS Deck (24)
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1

Amyotrophic lateral sclerosis is commonly called _________.

Lou Gehrig's disease

2

Epidemiology of ALS

M > F, 40-60 yo

3

Pathophysiology of ALS

degeneration/death of motor neurons in CNS; motor cortex, spinal cord, lower brainstem

4

Signs of ALS

- progressive weakness of voluntary muscles
- affects speech and swallowing
- NO SENSORY LOSS

5

What muscles are spared in ALS?

ocular, bladder/bowel, genitals

6

What lab value is elevated in ALS?

creatinine kinase

7

ALS treatment

No meds proven beneficial (Riluzole extends survival, Baclofen)

Support for breathing (tracheostomy), support for swallowing (gastrostomy), PT, speech synthesizers

8

Who is most likely to get MS?

females, 20-30 yo, Caucasian, Northern Hemisphere

9

4 subtypes of MS progression

Relapsing-Remitting
Primary Progression
Secondary Progression
Progressive-Relapsing

*never gets back to baseline

10

Etiology of MS

autoimmune inflammatory disease that causes demyelination of white matter in brain and spinal cord

11

clinically isolated syndrome

1st neuro episode resembling MS that lasts at least 24 hrs

12

Possible triggers of MS

viruses, low Vit D, enviro factors

13

signs/sx of MS?

- highly variable since based on location of lesions
- numbness/tingling, imbalance, optic neuritis, stiffness, changes in bowel/bladder, sexual dysfunction

14

Uhthoff's Phenomenon

increased symptoms with high temps

15

Lhermitte's Sign

shock running down back into limbs when neck flexed

16

What are the differences in history of ALS vs MS?

- ALS steady progression of sx, MS episodic
- ALS males 40-60 yo; MS females 20-30 yo
- Bladder/bowel/sex dysfunction only in MS
- MS commonly has abnormal MRI

17

What makes MS doubtful?

No symptoms above the neck, fhx of neurologic disease, persistent back pain, normal MRI

18

What imaging is done for MS?

MRI > CT
MRI w/ Gadolinium IV contrast
Not diagnostic, but crucial for assessing time progression of lesions or "plaques"

19

What criteria may help diagnose MS?

McDonald criteria, Poster Diagnostic criteria

20

PE tests that can follow progression of MS?

25 ft timed walk
9 hole peg test
Leg tone, tested supine for spasticity

21

How is MS treated?

NO CURE!
Disease Modifying Therapy (start early, slows progression, rescue from acute relapses)
- Chronic: Beta interferon injections, immunosuppressants, anti-inflams
- Acute: HD steroids, plasma exchange

22

What can PCPs do for MS patients?

Vit D supplements
Encourage regular izzies
Treat depression
Refer to PT/OT for home modifications and mobility aids

23

How are MS and ALS similar?

Both degeneration of CNS, progressive weakness, affect motor neurons, no known cures

24

Only way to definitively diagnose MS?

tissue biopsy on post-mortem exam