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Neurology > Multiple Sclerosis > Flashcards

Flashcards in Multiple Sclerosis Deck (23)
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1

What part of the nervous system does multiple sclerosis effect?

White matter of the CNS

2

What is multiple sclerosis?

Demyelinating disease in which the myelin sheaths of nerve cells in the brain and spinal cord are damaged

3

What is the process of demyelination involve?

Activated T cells cross blood brain barrier causing demyelination
Acute inflammation of myelin sheath
Loss of function

4

What feature is usually present with progression of multiple sclerosis?

Axonal loss

5

What is the most common age of onset for multiple sclerosis?

20-30 years old

6

What symptoms could be present during a relapse of MS?

Optic neuritis
Sensory symptoms
Limb weakness
Brainstem diplopia
Vertigo
Ataxia
Spinal cord symptoms
Bladder problems

7

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

8

What are some of the differential diagnosis that can be made from optic neuritis?

Sarcoidosis
Ischaemic optic neuropathy
Neuromyelitis optica
Toxic/drugs/B12 deficiency
Local compression

9

What are the signs of myelitis?

Bladder and bowel involvement
Weakness/ UMN changes below level
Sensory level numbness or pain

10

What are the signs that a person with MS is has entered into the progressive phase?

Fatigue
Temperature sensitivity
Sensory
Stiffness or spasms
Slurred speech
Swallowing problems
Balance problems
Bladder and bowel problems
Cognitive dementia
Diplopia

11

What would be found on examination of a patient with MS?

Afferent pupillary defect
Nystagmus/ abnormal eye movements
Cerebellar signs
Weakness
Spasticity
Hyperreflexia
Plantars extension

12

How is MS diagnosed?

More than 1 relapse at a different point in time

13

Why is gadolinium used during an MRI scan?

Shows up active areas of inflammation, separates old and new areas of inflammation

14

What other investigations are used to diagnose MS?

Lumbar puncture
Bloods
CXR
Visual/somatosensory evoked response

15

What are the different types of MS?

Relapsing remitting (RRMS)
Secondary progressive (SPMS)
Primary progressive (PPMS)
Sensory
Malignant

16

What is the treatment for MS?

Disease modifying treatment
General health and diet
Treatment of relapse
Symptomatic treatment

17

What is the first line treatment for disease modifying treatment?

Beta interferons/ glatiramer acetate (injection)
Teriflunomide (oral)
Dimethyl fumarate (oral)

18

What are the side effects of beta interferons?

Flu like symptoms
Injection site reaction
Abnormalities of blood count and liver function

19

What are the second line treatments for disease modifying treatment?

Natalizumab
Fingolimod
Alemtuzumab

20

What is the treatment for an acute relapse?

Look for underlying infection
Oral prednisone
Rehab (physio)
Symptomatic treatment

21

How would spasticity be treated?

Muscle relaxants
Anti spasmodics
Physiotherapy

22

How is constipation treated?

Laxatives

23

How is dysaethesia treated?

Amitriptyline
Gabapentin