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Flashcards in Multiple Sclerosis Deck (16)

Multiple Sclerosis

An autoimmune demyelinating disorder of the central nervous system that has relapses and remission


What is Charcot's triad for MS?

Nystagmus, intention tremor, scanning speech


Who is the typical MS patient?

Younger females between 20 and 50 of Northern European descent


What is the regional risk for MS?

Risk of MS increases as you go further from the equator - possibly related to vitamin D levels


What is the genetic component of MS?

It is related to genetics, but it is not a genetic disease as the risk factor between identical twins is only 25%


What are some environmental factors that influence MS?

Viral exposures are connected with MS - mainly EBV


What is the pathogenesis of MS?

T cells attach to, break down and cross the BBB
– Release interleukins that cause inflammatory response and disrupt the BBB
– Secrete pro-inflammatory cytokines leading to myelin destruction and neuronal death
– Cell may become “chronically active” within the CNS over time leading to progressive neurodegeneration


What ocular problem is highly associated with MS?

Optic neuritis from inflammation of the optic nerve
– Decreased monocular vision
• Often involving central vision
– Pain with eye movement
– Decreased red/green color


What is pathopneumonic for MS?

Internuclear Ophthalmoplegia


What clinical sign can be tested for and seen in MS?

Romberg sign: a sign indicating loss of proprioceptive control in which increased unsteadiness occurs when standing with eyes closed


How is MS diagnosed using imaging?

At least one T2 lesion—that is characteristic in appearance for MS—in at least two out of four locations considered characteristic for MS:
– juxtacortical
– periventricular -> MAIN ONE
– infratentorial
– spinal cord


What will be seen in the CSF of most MS patients?

Oligoclonal bands


What can be confused with MS but will have bilateral optic neuritis instead?

Neuromyelitis Optica


Acute Disseminated Encephalomyelitis

Large multifocal lesions that is found post-infectious often in children - should not be confused with MS


Progressive Multifocal Leukoencephalopathy

Caused by JC virus and will have multiple lesions present


What is the treatment for MS

- High doses of steroids
- Plasmapharesis and IVIg

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