Flashcards in multiple sclerosis Deck (22)
what is multiple sclerosis?
a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged
how does demyelination occur in MS?
activated T cells cross the blood brain barrier causing demyelination
what would you expect to see on an MRI of a patient with MS?
lesions or plaques
what is a "black hole"
area on an MRI where brain tissue has been lost as a result of inflammation in an MS plaque
how do most MS cases present?
with a relapse
an attack of demyelination or inflammation
what does the onset of MS present as?
gradual onset over days
what symptoms can present in an MS relapse?
can be bilateral spinal cord symptoms
what are some features of optic neuritis?
subacute visual loss
pain on moving eye
colour vision disturbed
initial swelling of optic disc
what MRI criteria is used to diagnose MS?
what investigations are used to diagnose MS?
bloods to exclude other inflammatory conditions
what are the different types of MS?
what are some poor prognostic indicators for MS?
multifocal symptoms and signs
motor symptoms and signs
what are some features of primary progressive MS?
often presents in 5th and 6th decade
what are some features of devics disease?
aquaporin 4 antibodies
antibody negative in some cases
what are 1st line disease modifying MS treatments?
beta interferons/glatiramer acetate
what are some side effects of 1st line MS injective treatment?
flu like symptoms
injection site reaction
abnormalities of blood count and liver function
what are some 2nd line treatments for MS?
what is progressive multifocal leukencephalopathy caused by?
how do you screen for PML?
JC antibody blood and urine every 6 months
what should you try and exclude in an acute relapse of MS?
look for the underlying infection so you can exclude the worsening of usual symptoms with intercurrent illness
how is spasticity in MS treated?