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Flashcards in Miscellaneous Neurological Disorders Deck (61)
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1

Multiple Sclerosis

Most common acquired disease of myelin

2

How demyelination occurs

Body mistakenly directs antibodies and WBCs against proteins in the myelin sheath
Results in inflammation and injury to the sheath

3

Areas of myelination are found where?

White matter of the brain, spinal cord, and optic nerve

4

Pathogenesis of MS

Peri-vascular infiltrates by lymphocytes and monocytes
MHC antigen expression
HLA-DR2

5

How is MS characterized?

Relapses with some degrees of recovery
Progresses to continual disease

6

Areas commonly affected in MS

Optic nerve
Corticobulbar tracts
Corticospinal tracts
Cerebellar tracts
Spinocerebellar tracts
Longitudinal fasciculus
Posterior cell columns of the spinal cord

7

Who is most commonly affected?

Ages 15-50
More common in women

8

Geographical factors where MS is commonly found

Temperate climates
Europe
Southern Canada
Norther US
Southeastern Australia

9

Environmental factors in MS

Viruses
Bacteria

10

Symptoms of MS

Weakness, numbness, tingling, or unsteadiness in a limb
Unilateral visual impairment
Fatigue
Spastic paraparesis
Diplopia
Disequilibrium
Muscle weakness
Sphincter disturbances
Dysarthria
Mental disturbance

11

Signs of MS

Optic neuritis
Opthalmoplegia
Nystagmus
Spasticity or hyperreflexia
Babinski sign
Absent abdominal reflexes
Labile/changed mood

12

Onset of MS

Younger patients- subacute or acute
Older patients- insidiously progressive myelopathy

13

Forms of the disease

Secondary progressive disease- acute relapses
Primary progressive disease- steady progression from onset

14

CSF results

Usually normal but can have
Protein elevations
Lymphocytosis
Elevated IgG
Myelin antibodies
Oligoclonal bands

15

MS diagnosis requirements

Intermittent or progressive CNS symptoms supported by evidence of two or more CNS white matter lesions occurring in an appropriately aged patient

16

Treatment categories of MS

Treat acute symptoms
Modify course of disease
Interrupt progressive disease
Treat continuing symptoms

17

Minimal affected patients and treatment

No specific treatment
Encourage to maintain healthy lifestyle
Physical therapy

18

Treatment of acute symptoms

Corticosteroids

19

Treatment of modifying disease

Interferon 1a
Interferon 1b
Glatiramer acetate

20

Treatment of progressive disease

Immunosuppressants such as:
Methotrexate (Rheumatrex)
Cyclophosphomide (Cytoxan)
Mitoxantrone (Novantrone)
Azathioprine (Imuran)

21

Tysabri (Natalzumab) in MS

Lab produced monoclonal antibody
Hamper movement of potentially damaging immune cells from the bloodstream across the "blood-brain-barrier"

22

Symptom treatment of MS

Dantrolene (Muscle relaxant)
Baclofen (muscle relaxant)
Modofinil (provigil)- CNS stimulant
Amantadine (anti-viral)
(Bethanechol)
Antidepressants

23

Cerebral Palsy cause

Caused by abnormalities in parts of the brain that control muscle movements

24

CP

Disease of childhood
Most children born with it but not detected

25

Define CP

Non-progressive disorder, but secondary orthopedic deformities are common

26

Ways brain damage occurs while developing

During pregnancy (75%)
During childbirth (5%)
After birth (15%)

27

Brain damage during pregnancy

Infections during pregnancy
Insufficient perinatal oxygen
Prematurity
Rh incompatibility

28

Brain damage during childbirth

Asphyxia during labor and delivery

29

Brain damage after birth

Brain injuries during the first two years of life (brain infections, head injuries)

30

Four classifications of cerebral palsy

Spastic
Athetoid
Ataxic
Mixed