Multiple sclerosis Flashcards
Define multiple sclerosis
Demyelination of the CNS. MS can’t be diagnosed by one episode-> episodes have to be ‘disseminated by time and space’
Which cells are affected in multiple sclerosis?
Oligodendrocytes (CNS myelinating cells)
What type of hypersensitivity reaction is MS?
Type 4
Describe pathophysiology for MS
- Molecular mimicry
- Initial infection-> the antigen is
recognised by T helper cells, after infection the myelin is recognised as an antigen leading to
cytokines being released and antibodies being formed
What are the risk factors/causes for MS?
- Female 20-40 (white)
- Autoimmune disease
- Family history
- EBV
- Genetic (HLA-DR2)
- Low vitamin D
- Smoking
- Obesity
What are the different types of MS?
- Relapsing-remitting
- Primary progressive
- Secondary progressive
Describe relapsing-remitting MS
Symptoms -> incomplete recovery -> symptoms
Describe primary progressive MS
Gradual degeneration without recovery
Describe secondary progressive MS
Relapsing remitting –> primary progressive
- 75% of R-R cases evolve into this
What is the 1st presenting sign of MS?
Optic neuritis
What are other symptoms of MS?
- Paraesthesia
- Blurred vision
- Uhthoff’s phenomenon
What is Uhthoff’s phenomenon?
Symptoms are exacerbated with heat eg. after a shower
What are the signs of MS?
- Optic neuritis (inflamed optic nerve, can’t see red properly)
- Internuclear ophthalmoplegia (lateral gaze impaired, damaged medial longitudinal fasciculus)
- Brainstem signs
- Sensory signs
- UMN signs (not LMN)
- Lhermitte phenomenon (electric shock sensation w/ neck flexion)
- Charcot neurological triad
What is Charcot’s neurological triad?
- Dysarthria (scanning or staccato speech)
- Nystagmus
- Intention tremor
How do you diagnose MS?
McDonald criteria
- 2 or more attacks disseminated in time (separate) + space (different part of CNS affected
