Multiple sclerosis

Question 1

Definition of MS and 5 Stages

Answer 1

A chronic demyelinating disease of the CNS characterised by the inflammatory process resulting in the widespread degeneration of the CNS leading to severe neurological deficits
1- Disruption of the blood-brain barrier
2- leakage of inflammatory cells
3- the destruction of oligodendrocytes and myelin sheath
4- slower nerve signals as the rate of transition is limited
5- plaques form within the CNS

Question 2

Causes and types

Answer 2

1- environmental
2- viral
3- genetic, not inherited but increased risk

• benign
• relapsing/remitting
• secondary progressive
• primary progressive

Question 3

Signs and symptoms

Answer 3

• Fatigue
• Difficulty walking
• Balance issues
• Ataxia
• Sensory deficits
• visual issues
• bladder control
• Problems thinking, planning, learning
• increased muscle tone (rigidity)

Question 4

What is a relapse

Answer 4

Clinically relevant symptoms 
symptoms last longer than 24h 
symptoms 30 days post last attack 
objective tests 
symptoms not worsened by infection

Question 5

Treatment and medication

Answer 5

5 days at home steroids
3-5 in-hospital steroid injections

Disease-modifying drugs:

• reduce the number of relapses
• reduce the severity of relapses
• reduce disability build-up

Question 6

Factors that improve prognosis

Answer 6

• being female
• diagnosis <40 years
• few relapses in the initial years
• full recovery each relapses
• more time between releases
• Symptoms mainly sensory in nature