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Demyelinating Disease
Clinical and Path Aspects. 15.3.07
27
Other
Not Applicable
03/17/2007

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Cards

Term
Define demyelination
Definition
myelin destruction out of proportion to axonal damage
Term
define actutes, disseminated excephalomyelitis
Definition
a single episode, with inflammatory CSF, that does not nec evolve to MS, can be recurrent in kids
Term
what is a clinically issolated syndrome?
Definition
a single episode of demyelination (ie, optic neuritis)
Term
Compare and contrast MS and Acute disseminated encephalomyelitis
Definition
ADE = acute, MS = chronic
Term
Define MS
Definition
a chronic, progressive immune-mediated CNS disease characterized by demylination and axonal loss leading to neurological impairment and disability. early treatment is key.
Term
Is MS itself often directly fatal?
Definition
No.
Term
Which viruses are suspected to cause MS?
Definition
Rabies, EBV, HHV-6, HTLV Lyme Disease
Term
Which deficiency may cause MS?
Definition
Vitamin D
Term
Is there a genetic component to MS?
Definition
yes.
Term
Where is there highest concentration of people with MS? Lowest?
Definition
Highest- N. US/Canada, Western Europe

Lowest--africa
Term
Where are the most susceptible parts of the CNS to MS demylenation?
Definition
MS can involve any area of CNS, but optic nerve and spinal cord are most symptomatic.
Term
Is MS a continuum?
Definition
Yes--from single episode of demyelination (monosymptomatic demyelinating disease of clnical isolated syndrome) to a continous neurological deterioration with or without occasional acute worsening.
Term
What are the 2 classic symptoms of MS?
Definition
visual symptoms and difficulty of ambulation
Term
What are the 2 other symptoms of MS?
Definition
cognitive problems, and sensitivity to high temp (symptoms get worse.
Term
what is average age of onset
Definition
25-35 years old
Term
Do more men than women get it?
Definition
No--more women than men
Term
Name the 4 MS classification:
Definition
Monosymptomatic demyelination (Not MS, but it can predispose)

2. Relapsing remitting

3. Secondary progressive (fewer "episodes," just get progressively worse)

4. Primary progressive. No relapses, just get worse. It's a bad type of MS--not much inflammation--and we only have drugs to treat the inflammation.
Term
Define MS related optic neuritis
Definition
Monocular loss of vision,

2. pain

3. Optic swelling followed by atrophy

4. prolonged visual evoked responses (VERs)

5. recovery with time.
Term
List Optic symptoms of MS
Definition
1. Looks at a pattern reversal (checked squares)

2. prolonged delay indicative of visual dysfuction.

3. internuclear ophthalmoplegia
Term
define internuclear ophthalmophegia
Definition
VOR doesn't work--2 eyes can't follow finger
Term
Does prescence of oligoclonal bands suggest normal or MS?
Definition
MS
Term
What CNS symptoms in MS?
Definition
sensory complaints (pain, LOsens), ambulatory difficulties, loss of upper extremity coordination
Term
What are the 3 different types of MS Path, and what do they mean?
Definition
1. Contrast Enhancing Lesion--inflammation

2. White Matter Lesion--demyelination

3. Black Hole--axonal loss/gliosis
Term
what are plaques?
Definition
lesions=areas of demyelination = lymphocytes, macrophages
Term
what is the biggest change over time in terms of how the disease manifests itself? Ie, early vs late main components.
Definition
1. Early--inflammation, demylenation (relapse)

2. Late--atrophy, axonal loss, increasing tissue destruction (disability)
Term
Tx MS?
Definition
IFN--Betas--shown to have fewer lesions
Term
what effects do we want to have future MS treaments?
Definition
agents that decrease lymphocitye and monocyte recruitment into CNS
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