Multiple Sclerosis Flashcards
Pthological process of MS
demylination of neurones through repeated/persistant inflammation and may eventually result in the loss of the neurons
Age on onset for MS
Often 20-30
Things that might increase the chance of developing MS
Genetics, autoimmune disease, female (slightly) temparate climates (?), vitamin d (?), viruses eg Epsteinbarr (?)
What is the initial presentation of MS
Initially presents as some form of neuronal inability (demylenation of white matter in CNS), over a few days and stabilises within days/weeks, may or may not fully recover
What can relapses present as?
-Optic neuritis
-Sensory symptoms
-Limb weakness
-Brainstem (Diplopia, Vertigo/Ataxia)
- Spinal cord (bilateral motor and sensory symptoms/ Bladder involvement)
What is relative afferent pupillary defect and when would it present? What are the other signs of this?
It is when if you check the pupillayry reflex, then if you shine the light in the good eye, both eyes will constrict, if you shine the light in the bad eye, both eyes will dilate and then back to the good eye and both pupils will constrict again.
Can present as part of optic neuritis.
Other symptoms may include:
-Subacute visual loss
-Pain on moving eye
-Colour vision impaired
Will see optic disc swelling and later optic atrophy
What is internuclear opthalmoplegia?
When if you look right then left, one of the eyes won’t adduct. Present as part of a brainstem relapse
What can a spinal chord lesion present as?
Partial or Transverse (complete) Myelitis
-Sensory level often with band of hyperaesthesia
-Weakness/ upper motor neurone changes below level of demyelination
-Bladder and bowel involvement
What is the Demylenation due to?
Autoimmune, activated T cells crossing Blood brain barrier, inflammation and attack on myelin -> loss of function
What is glyosis and can this be seen on an mri scan?
Yes, present as white blobs (areas of inflammation) -> Glial cells (astrocytes) proliferation and scar tissue being laid down.
What are the needed for MS diagnosis?
At least 2 relapses in different areas of CNS - months or years apart
Posers criteria (purely clinical diagnosis)
MAcdonald Criteria (involves being able to see areas of inflammation or neuronal loss on MRI scan alongside the clinical symptoms)
What is clinically isolated syndrome?
No further episodes
What can induce relapses?
Being ill (infections)
3 months post-partum (although reduced chance during pregnancy)
What causes the progression and development of MS?
Axonal loss important in disease progression and development of persistent disability
What is dysesthsia?
Painful pins and needles
