Multiple Sclerosis - Clinical

Question 1

What are the most common initial presentations of MS?

Answer 1

Optic Neuritis - Inflammation of optic nerve
(partial or total unilateral visual loss/pain behind eyes/loss of colour discrimination)

Transverse myelitis - focal inflammation within the spinal cord
(Sensory or motor symptoms such as paraesthesia and weakness/urinary symptoms(urgency,frequency))

Brainstem syndromes
Ataxia/Eye movement abnormalities that can cause diplopia/bulbar muscle problems causing dysphagia or dysarthria

Question 2

What is the diagnostic process for MS?

Answer 2

MRI of brainstem/spinal cord and brain looking for lesions and immunoblotting of CSF/Blood serum, for detection of oligoclonal bands of IgG

Question 3

What additional data would be needed for MS diagnosis in a patient that presents with two or more relapses and objective clinical evidence of one lesion?

Answer 3

One or more MRI detected lesion typical of MS or a further relapse showing damage to another part of CNS

(Dissemination in time is already shown by occurrence of more than one relapse)

Question 4

Where is MS most prevalent globally?

Answer 4

Greenland, Canada, Ireland and Sweden have the highest prevalence. Prevalence increases in more western countries.

Question 5

Which sex has a higher prevalence of MS?

Answer 5

Females

Question 6

What virus is commonly associated with triggering Multiple Sclerosis?

Answer 6

EBV (Epstein-Barr Virus)

Question 7

What are the subtypes of MS?

Answer 7

Relapsing-remitting
Primary progressive
Secondary progressive (following relapsing-remitting)
Progressive relapsing