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Neuro MS

Neurology Multiple Sclerosis

QuestionAnswer
Underlying Factors of MS Infectious agent, genetic predisposition, Environmental Factors, abnormal immunologic response.
MS definition an inflammtory demyelinating disorder of the CNS that affects physical, cognitive, psychologic function. Autoimmune. Axonal loss (which is not repairable)
MS epidemiology Mean age of onset: 20-40 years, F:M=2-3:1
Common manifestations of MS optic neuritis, transverse myelitis, paresthesias, ataxia, weakness or incoordination, spasticity, cognitive impairment
MS Abnormalities may be found on _______ before symptoms are present MRI
Optic neuritis symptoms Pain behind eyes, can't move eyes.
Onset of MS comes on over a day or two, may come on and off for weeks. 85% is relapsing MS
How does MS affect the brain? Causes faster shrinkage
Secondary Progressive MS Relapsing --> Progressive MS (occurs after 10 years in 50% of cases)
Therapy is most effective in which type of MS? Relapsing MS. This is early in the disease when the autoimmune inflammation is the major concern. This is what meds can work on
Benign MS Complete recovery between relapses. Uncommon
T1 MRI CSF is black, "black hole" (CSF fluid)
T2 MRI CSF is white. This scan is followed up with a FLARE scan which then turns all of the normal water back to black
Areas of active dye an active lesion right now
Diagnosis of MS Hx: involvement of the CNS "separated in space and time". Exam - evidence of "dissemination in space" CNS manifestations. MRI lesions or plaques, Evoked potentials, CSF - evidence of oligoclonal bands or increased IgG index.
Evoked potentials measures Slowing of information conduction
Location for typical MS lesions Alongside the ventricles (usually oval and perpendicular to it) and in the corpus collosum
MS MRIs reveal Larger ventricles and shrunken brain, and white spots
Which is permanent, Demyelination or axonal loss? Axonal loss.
Treatment Options for Relapsing forms of MS Disease-modifying treatments (IFNs and glatiramer acetate), Immunosuppressive drugs, Corticosteroids. Safe, moderately effective, decrease relapses by 1/3
What does the CSF show in MS patients Oligoclonal bands or increased IgG index
Created by: ltm12
 

 



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