Week Five - Multiple Sclerosis Flashcards
(47 cards)
What is MS?
An auto-immune disorder with both inflammatory and neurodegenerative pathologies
- affects the neurons and is heterogenous
What are the 2 major processes that affect MS?
demyelination - occurs due to inflammation
axonal disruption
What are the 2 white blood cells that help immune functioning?
B cells
T cells
Where do B cells develop and what do they do?
Develop in bone marrow and produce antibodies that ambush foreign antigens in the bloodstream.
Where do T cells develop and what do they do?
Develop in the thymus gland and direct attacks on foreign substances (eg bacteria, viruses)
What do T cells produce?
Substances called cytokines that direct responses and activities in other immune cells
What is MRI success at looking at MS lesions?
Cannot always detect small fine grain changes
When do MS lesions occur?
When there is a lot of inflammation in the brain
Main symptoms of MS
Central (unvisible) eg fatigue - most common, impairments Visual Speech (dysarthria), Throat (dysphagia) Musculoskeletal Sensation Bowel Urinary
Why do so many individuals with MS live away from the equator?
Because they typically have temperature intolerance - move to colder climates
Onset age of MS?
Late 20s, early 30s
Gender differences in MS?
x2 more females
Common misdiagnosis of MS?
Depression
What are the 4 different types of MS?
Progressive-relapsing
Secondary progressive
Primary progressive
Relapsing-remitting
What is PROGRESSIVE-RELAPSING MS associated with?
A steady decline since onset with superimposed attacks
What is SECONDARY PROGRESSIVE MS associated with?
Initial relapsing-remitting MS that suddenly begins to have decline without period of remission
What is PRIMARY PROGRESSIVE MS associated with?
Steady increase in disability without attacks
What is RELAPSING-REMITTING MS associated with?
Unpredictable attacks which may or may not leave permanent deficits followed by periods of remission.
What do we need to diagnose MS?
At least 2 occurrences of flare ups in the brain (space) and evidence that there are 2 distinct lesions in the brain from MRI (time)
Why is the EDSS scale not always appropriate?
Too much focus on physical functioning and not enough of cognitive and invisible symptoms
What causes MS/risk factors?
Interaction of
- immunological and environmental factors (vitamin D deficiency - white collar workers)
- personal factors (age, gender)
- infectious factors (epstein-barr)
- smoking
- genetics (ethnic background - vikings disease, siblings/relative)
Cognitive impairments occur largerly independent of what?
Disease duration
Most people report what type of cognitive impairments?
Mild to moderate
Do cognitive impairments occur in a uniform pattern?
No, they are heterogenous across people