Chronic autoimmune, demyelinating disease of the Central Nervous System (CNS). Causes plaques/scarring in white matter.

Affects women more than men, ages 20-50. More common in colder climates (e.g., Northeastern US, Canada).

Characterized by periods of remission and exacerbation (flares). Exacerbations become more frequent over time.

Fatigue and Diplopia (double vision) are often the earliest and most common symptoms.

Diplopia, nystagmus, scotoma (blind spot), optic neuritis (pain with eye movement).

Intention tremor, ataxia, spasticity, paresthesia (numbness/tingling), Lhermitte's sign (electric shock down spine).

Urinary frequency/urgency/incontinence. Cognitive changes: memory loss, slowed processing.

Temporary worsening of MS symptoms (especially vision) with increased body temperature (hot bath, fever).

Used to shorten duration and severity of exacerbations (e.g., IV methylprednisolone).

Interferons, glatiramer acetate, monoclonal antibodies (e.g., natalizumab) to reduce relapse frequency.

Plan major activities for the morning when energy is highest. Prioritize rest and avoid overheating.

Diagnostic Test - Lumbar Puncture

Elevated IgG index and oligoclonal bands in CSF, not found in serum, indicate intrathecal antibody production.

Symptom - Lhermitte's Sign

Electric shock sensation down spine/limbs upon neck flexion. Indicates cervical spinal cord lesion.

Symptom Management - Spasticity

Baclofen (oral or intrathecal pump), tizanidine, diazepam. Physical therapy and stretching essential.

Prioritize activities, schedule rests, moderate exercise (cool pool), medications like amantadine or modafinil.

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Multiple Sclerosis

Question	Answer
Patho	Chronic autoimmune, demyelinating disease of the Central Nervous System (CNS). Causes plaques/scarring in white matter.
Demographics	Affects women more than men, ages 20-50. More common in colder climates (e.g., Northeastern US, Canada).
Characteristics	Characterized by periods of remission and exacerbation (flares). Exacerbations become more frequent over time.
Key Symptoms	Fatigue and Diplopia (double vision) are often the earliest and most common symptoms.
Eye Effects	Diplopia, nystagmus, scotoma (blind spot), optic neuritis (pain with eye movement).
Motor Effects	Intention tremor, ataxia, spasticity, paresthesia (numbness/tingling), Lhermitte's sign (electric shock down spine).
Bladder & Cognitive	Urinary frequency/urgency/incontinence. Cognitive changes: memory loss, slowed processing.
Uhthoff's Sign	Temporary worsening of MS symptoms (especially vision) with increased body temperature (hot bath, fever).
Corticosteroids	Used to shorten duration and severity of exacerbations (e.g., IV methylprednisolone).
Modifying Therapies	Interferons, glatiramer acetate, monoclonal antibodies (e.g., natalizumab) to reduce relapse frequency.
Energy	Plan major activities for the morning when energy is highest. Prioritize rest and avoid overheating.
Diagnostic Test - Lumbar Puncture	Elevated IgG index and oligoclonal bands in CSF, not found in serum, indicate intrathecal antibody production.
Symptom - Lhermitte's Sign	Electric shock sensation down spine/limbs upon neck flexion. Indicates cervical spinal cord lesion.
Symptom Management - Spasticity	Baclofen (oral or intrathecal pump), tizanidine, diazepam. Physical therapy and stretching essential.
Fatigue Management	Prioritize activities, schedule rests, moderate exercise (cool pool), medications like amantadine or modafinil.

Created by: Wasurenboh

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