Multiple Sclerosis Flashcards Preview

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Flashcards in Multiple Sclerosis Deck (18):
1

What is multiple sclerosis?

Autoimmune demyelinating disorder of the CNS

2

Generally speaking, who gets MS?

Typically a young (20-40s) female of northern European descent

However, kids, older adults, and men can get MS too!

3

Geographic distribution of MS

Risk for MS increases with distance from the equator

4

What is the genetic predisposition for MS?

HLA-DR2

5

MS
Pathogenesis

Something activates the immune system to attack myelin in the CNS

T cells attach, break down, and cross the BBB

Cause progressive neurodegeneration over time

6

Optic Neuritis in MS
Describe the symptoms

Inflammation of the optic nerve with...

Decreased monocular vision

Pain with eye movement

Decreased Red color

Afferent pupillary defect

7

Internuclear Ophthalmoplegia

Where is the lesion?

Lesion in the MLF, which coordinates lateral movements of the eye

This condition is almost pathopneumonic for MS

8

Spinal Cord Syndrome
Describe the symptoms

Partial myelopathy

Lhermitte's sign --> electric shock sensation with neck flexion

Numbness anywhere in the torso

9

Romberg Sign
What is it?

Impaired proprioception, commonly seen in MS because MS loves to affect the dorsal roots

Ask them "How do you wash your hair in the shower?"

10

What are the 4 locations that are considered characteristic for MS lesions?

Juxtacortical

Periventricular

Infratentorial

Spinal cord (limited to one vertebral level per lesion)

11

What are Dawson's fingers?

White lesions seen on MRI --> lesions are like fingers sticking out of the corpus callosum

12

CSF findings in MS patients

May find Oligoclonal bands (markers of immune activity within the CNS)

Not specific, but they support an MS diagnosis

13

Neuromyelitis Optica

Pathology

Autoimmune process with antibodies directed against aquaporin 4 channel

Bilateral optic neuritis

Transverse myelitis

14

Acute Disseminated Encephalomyelitis (ADEM)

Who would get this disease? What is seen on scans?

Huge white lesions seen in a child who recently had an infection

15

Progressive Multiform Leukoencephalopathy

Caused by...? Symptoms?

JC virus infection of the oligodendrocytes

Causes rapidly progressing neurologic symptoms that lead to death

16

Treatment of MS acute attacks

High dose steroids -- IV methylprednisolone

17

Long term treatment of MS with _____ slows progression of the disease

IFN-Beta

18

Generally speaking, how is MS diagnosed?

It is a clinical diagnosis, but MRI is often helpful in confirming it. We don't really need to look at CSF anymore for MS diagnosis

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