Flashcards in Multiple Sclerosis Deck (23)
What part of the nervous system does multiple sclerosis effect?
White matter of the CNS
What is multiple sclerosis?
Demyelinating disease in which the myelin sheaths of nerve cells in the brain and spinal cord are damaged
What is the process of demyelination involve?
Activated T cells cross blood brain barrier causing demyelination
Acute inflammation of myelin sheath
Loss of function
What feature is usually present with progression of multiple sclerosis?
What is the most common age of onset for multiple sclerosis?
20-30 years old
What symptoms could be present during a relapse of MS?
Spinal cord symptoms
What are the clinical features of optic neuritis?
Subacute visual loss
Pain on moving eye
Colour vision disturbed
Initial swelling of optic disc
Optic atrophy later on
Relative afferent pupillary defect
What are some of the differential diagnosis that can be made from optic neuritis?
Ischaemic optic neuropathy
What are the signs of myelitis?
Bladder and bowel involvement
Weakness/ UMN changes below level
Sensory level numbness or pain
What are the signs that a person with MS is has entered into the progressive phase?
Stiffness or spasms
Bladder and bowel problems
What would be found on examination of a patient with MS?
Afferent pupillary defect
Nystagmus/ abnormal eye movements
How is MS diagnosed?
More than 1 relapse at a different point in time
Why is gadolinium used during an MRI scan?
Shows up active areas of inflammation, separates old and new areas of inflammation
What other investigations are used to diagnose MS?
Visual/somatosensory evoked response
What are the different types of MS?
Relapsing remitting (RRMS)
Secondary progressive (SPMS)
Primary progressive (PPMS)
What is the treatment for MS?
Disease modifying treatment
General health and diet
Treatment of relapse
What is the first line treatment for disease modifying treatment?
Beta interferons/ glatiramer acetate (injection)
Dimethyl fumarate (oral)
What are the side effects of beta interferons?
Flu like symptoms
Injection site reaction
Abnormalities of blood count and liver function
What are the second line treatments for disease modifying treatment?
What is the treatment for an acute relapse?
Look for underlying infection
How would spasticity be treated?
How is constipation treated?