Multiple Sclerosis Flashcards
What is multiple sclerosis (MS)?
MS is a chronic autoimmune demyelinating disease of the central nervous system (CNS) characterised by inflammation, demyelination, and axonal degeneration.
What are the common symptoms of MS?
Fatigue, vision problems, weakness, numbness, balance and coordination issues, and bladder or bowel dysfunction.
What is the most common initial symptom of MS?
Optic neuritis, presenting with painful vision loss and reduced colour vision in one eye.
What are the main subtypes of MS?
Relapsing-remitting MS (RRMS), primary progressive MS (PPMS), secondary progressive MS (SPMS), and progressive-relapsing MS (PRMS).
What is relapsing-remitting MS (RRMS)?
A subtype characterised by episodes of new or worsening symptoms (relapses) followed by periods of remission.
What is primary progressive MS (PPMS)?
A subtype involving continuous worsening of symptoms from disease onset without clear relapses or remissions.
What is the aetiology of MS?
The exact cause is unknown, but it is thought to involve a combination of genetic susceptibility and environmental triggers (e.g., vitamin D deficiency, infections).
What is the pathophysiology of MS?
Autoimmune attack on myelin sheaths leads to demyelination, inflammation, and neuronal damage in the CNS.
What is the role of oligoclonal bands in MS diagnosis?
The presence of oligoclonal bands in cerebrospinal fluid (CSF) suggests inflammation within the CNS and supports an MS diagnosis.
What imaging modality is key in diagnosing MS?
MRI of the brain and spinal cord, showing white matter lesions consistent with demyelination.
What is the McDonald criteria for MS diagnosis?
A set of clinical, radiological, and laboratory findings used to diagnose MS, requiring evidence of lesions disseminated in time and space.
What are the visual symptoms associated with MS?
Optic neuritis, diplopia, nystagmus, and internuclear ophthalmoplegia.
What is Lhermitte’s sign?
An electric shock-like sensation down the spine, triggered by neck flexion, often seen in MS.
What are common sensory symptoms in MS?
Numbness, tingling, pain, or altered sensation, often in a patchy or asymmetrical distribution.
What is Uhthoff’s phenomenon?
Worsening of MS symptoms with increased body temperature, such as during exercise or fever.
What is the role of disease-modifying therapies (DMTs) in MS?
DMTs reduce the frequency and severity of relapses and slow disease progression in relapsing forms of MS.
What are examples of DMTs used in MS?
Interferon-beta, glatiramer acetate, natalizumab, fingolimod, and ocrelizumab.
How are acute MS relapses treated?
High-dose corticosteroids (e.g., methylprednisolone) to reduce inflammation and shorten relapse duration.
What symptomatic treatments are used in MS?
Medications for spasticity (e.g., baclofen), fatigue (e.g., amantadine), bladder dysfunction, and pain management.
What is the typical prognosis of MS?
MS is a lifelong condition with variable progression; some patients experience minimal disability, while others may develop significant impairment.
What is the prevalence of MS in the UK?
MS affects approximately 1 in 600 people, with higher prevalence in women and those living farther from the equator.
What are the risk factors for MS?
Female gender, family history, low vitamin D levels, smoking, and certain infections (e.g., Epstein-Barr virus).
What are the main differential diagnoses for MS?
Neuromyelitis optica, systemic lupus erythematosus, sarcoidosis, and vitamin B12 deficiency.
What role does physiotherapy play in MS management?
Physiotherapy helps improve mobility, strength, and coordination while addressing spasticity and fatigue.
