Term
| Describe the generalized characteristics of MS |
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Definition
| Progressive, Multifocal in Time and Space neurologic disease with relapses and remissions |
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Term
| What is the most common cause of corpus callosum demyelination |
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Definition
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Term
| What are the Diagnostic results consistant with MS? |
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Definition
MRI lesions
CSF oligobanding or IgG > than serum
EMG(Visual Evoked Potential): delayed but preserved wave
Hot bath |
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Term
| What characterizes a positive MRI result |
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Definition
3 of 4 of the following:
9 Supratentorial plus cord lesions or 1 with Gd enhancement
3 periventricular lesions
1 infratentorial or cord lesion
1 juxacortical lesion |
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Term
| What are the most common symptoms of MS |
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Definition
Numbness/Paresthesias/Weakness
Visual: diplopia, intranuclear opthalmoplegia, vision loss
Gait/Incoordination
Bladder Dysfunction |
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Term
| Who is most likely to get MS |
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Definition
| 15-50 yr old Females in cold climate with family history |
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Term
| What are possible causes of MS |
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Definition
Infection: EBV, HHV-6
Genetics
Sunlight
Myelin Proteins:
Myelin Basic Protein
Myelin Oligodendrocyte Glycoprotein,
Oligodendrocyte-Specific Protein
Proteolipid Protein
Milk Protein:
Butyrophilin
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Term
| What is the pathologic histology of a MS lesion |
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Definition
Injury to white matter and axons
Pervenular lymphocytic Infiltrate(Dawson's Finger) |
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Term
| What is the appearance of an MS lesion on MRI |
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Definition
Ovoid typically periventricular lesion
Arranged Perpendicular to the ventricle
Can occur in any white matter area |
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Term
| What is the immunopathogenesis of MS |
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Definition
Lymphocyte predominately T-cells adhere and transverse Blood brain barrier
Activation occurs in white matter with cytokine production and inflamation |
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Term
| What are the types of clinical courses seen in MS |
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Definition
Benign
Progressive Relapse and Remission
Secondary Progressive
Primary Progressive |
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Term
| What is the treatment for an acute MS attack |
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Definition
Methylpredisone preferably IV
Alternatives: IVIG or dexamethasone |
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Term
| What are the disease modifying Treatments for MS and what is their mechanism |
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Definition
IFNs: Betaseron(1b), Avonex, Rebif
decrease cytokine release
Glatirimir acetate: Copaxone
Neurolipid causing bystander effect to shift to Th2 response
Novantrone: immunosuppression
Adhesion Molecule Inhibition: Tysabri
Blocks VCAM-1 Antigen on leukocytes preventing access to CNS |
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Term
| What is the most common cause of bilateral trigeminal neuralgia |
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Definition
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Term
| What is progressive multifocal leukoencephalopathy an what patients get it |
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Definition
| JC viral induced demyelination seen in immunosupressed AIDS, on tysabri (MS patients) |
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Term
| What is central pontine Myelinolysis |
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Definition
| Acute rise in sodium causes pontine demyelination |
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Term
| What is the timeframe for a MS attack |
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Definition
Lasts >24 hrs
30 days between attacks |
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Term
| What MRI results indicate dissemination in time, typical of MS? |
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Definition
A new Gd enhancing lesion 3 months after an attack or
A new T2 lesion 30 days after an attack |
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Term
| Signs and treatment of Optic Neuritis? What percent progress to MS |
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Definition
Centrocecal loss
Retrobulbar neuritis-> Difficulty w/ eye movements
Tx: Steroids
MS: 56%
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