MS and weakness

Question 1

what are signs of UMN weakness?

Answer 1

• increased tone (spasticity)
• brisk reflexes
• clonus
• positive Bakinski sign (extensor)

Question 2

what are signs of LMN weakness?

Answer 2

• wasting (atrophy)
• decreased tone
• loss of reflexes
• fasciculations
• negative Bakinski sign (flexor)

Question 3

what do nerve conduction studies examine?

Answer 3

conduction velocity and amplitude of nerve signals

Question 4

what is multiple sclerosis?

Answer 4

demyelination of the CNS, which causes plaques

- disrupts the conduction of nerve impulses

Question 5

What is the most common initial presentation of MS?

Answer 5

Sensory signs - numbness, coldness, pins and needles, swelling, tightness

Question 6

What are some signs and symptoms of MS?

Answer 6

Sensory signs - numbness, coldness, pins and needles, swelling, tightness

Visual signs - double vision, internuclear ophthalmoplegia

Motor signs - weakness in legs, +ve Babinski

• dizziness, facial numbness, nystagmus, cerebellar tremor, depression, fatigue

Question 7

What are some differential disorders for MS?

Answer 7

• optic neuritis
• spinal cord syndromes
• brain stem syndromes
• CNS disease

Question 8

What are the four courses of MS progression?

Answer 8

1) Clinically isolated syndrome - one episode of symptoms caused by inflammation and demyelination, does not meet diagnostic requirement for MS
2) Relapsing remitting - relapses followed by recovery
3) secondary progressive - progressive increase in disability
4) primary progressive - deterioate from onset

Question 9

What are evoked potentials and how are they used to diagnose MS?

Answer 9

Evoked potentials - measures the response of the nervous system to sensory stimuli
Visual evoked potential (VEP) - testing optic nerve demyelination