Multiple sclerosis

Question 1

Aetiologies?

Answer 1

Autoimmune with unknown triggerViral MS

Question 2

Pathology?

Answer 2

qAutoimmune inflammation of myelin sheath surrounding nerves causing demyelination Resolving of the lesions incomplete –> scarring Axonal loss in later disease

Question 3

Signs and symptoms?

Answer 3

Common presentation = relapsing symptoms, sensory signs (dysaethesia, optic neuritis, trigeminal neuralgia), UMN signs, GU signs (erectile, urinary), cognitive signs (amnesia, moodiness) Rarer pattern = as above with progressive worsening, no relapse

Question 4

Investigations and Findings?

Answer 4

MRI scan - lesions show up as white plaques, axonal loss as black holes Lumbar Puncture - CSF oligoclonal bands

Question 5

Management?

Answer 5

No cure Immunosuppressants can lessen severity of relapses Biologics lessen frequency, Monoclonal abs prevent BBB crossingMDT based

Question 6

Complications?

Answer 6

Wheelchair bound Life expectancy is reduced