Multiple sclerosis Flashcards
(42 cards)
What is optic neuritis and what does it cause?
Inflammation of the optic nerve - causes pain and loss of vision
What is the prognosis of optic neuritis (how many go on to return to visual acuity)?
95% return to visual acuity of 6/12 or greater within 12 months
What is the treatment for optic neuritis, does this affect final visual acuity?
High dose steroids - speed up recovery but have no effect on final visual acuity
What is the association between optic neuritis and MS?
50% of people who have suffered from optic neuritis go on to develop MS within 10 years
What is transverse myelitis, what is the prognosis and symptoms?
Inflammation inside the spinal cord - often pure sensory, may affect the bladder, experience Lhermittes phenomenon. It is often mild with a good prognosis
What is Lhermittes phenomenon?
Sudden, uncomfortable sensation which travels from your neck down your spine - like electric shocks going through your body
What is the association between transverse myelitis and MS?
50% of sufferers go on to develop MS
What kind of diagnosis is MS?
A clinical diagnosis
What criteria aid in the diagnosis of MS?
Macdonald criteria
How would optic neuritis and transverse myelitis occur in clinically definite MS?
Optic neuritis and transverse myelitis at different times
What 3 situations involving optic neuritis and transverse myelitis would not be clinically definite MS?
1) Myelitis and optic neuritis at the same time
2) Recurrent myelitis
3) Recurrent or sequential optic neuritis
What is the most common cause of neurological disability in young adults in the UK?
MS
Which sex is more susceptible to MS?
Females
What is the most common age of onset of MS?
30-40 years
What are the highest risk ethnicities and lowest risk ethnicities for MS?
Highest risk: Northern European, US Caucasians, Canadians
Lowest risk: African blacks, orientals
What is thought to be the reason behind the association between prevelance of MS and latitude?
Prevalence is strongly dependent on latitude - due to environmental factors such as habitat, diet, infections
What is MS?
A disease of the CNS - an inflammatory reaction in the CNS causes loss of myelin and slowing of nerve conduction, get areas of demyelination and loss of axons
What are thought to be the 2 main possible mechanisms behind demyelination in MS?
1) Immune cell mediated injury - auto Ab activate lymphocytes which activate macrophages and CD8+ cells to attack the axon myelin
2) Antibody mediated injury - Ab to myelin cause complement to attack the myelin of axons
What are disease modifying drugs?
Group of drugs used in the treatment of relapsing multiple sclerosis
What are the 4 types of disease progression in MS?
1) Relapsing-remitting MS - get flare ups and periods of improvement but generally relapses get worse over time
2) Primary progressive MS (10% of cases) - MS gets gradually worse over time with no periods of remitting
3) Secondary progressive MS - initially relapsing and remitting then becomes progressive and no longer get any periods of improvement
4) Progressive relapsing MS (
How effective is the DMD Interferon Beta - at which point is it most effective?
Reduces the number of relapses by 1/3
Effective early in the disease course
No evidence of long term effect on disability
What is the sight of injection, frequency and side effects of the DMD Betaferon 1b?
Subcut injection
Alternate days
Side effects = flu like symptoms, ISR
What is the sight of injection, frequency and side effects of the DMD Avonex 1a?
IM injection
Once weekly
Side effects = flu like symptoms
What is the sight of injection, frequency and side effects of the DMD Refib 1a?
Subcut injection
3 times a week
Side effects = flu like symptoms, ISR
