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Multiple Sclerosis
Neuro Assessment 8
25
Anatomy
Graduate
10/27/2011

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Cards

Term
What is the most common demyelinating disease in humans?
Definition
Multiple Sclerosis
Term
What is MS?
Definition
Chronic, inflammatory disease of the CNS
Myelin and neurons and axons are destroyed
Plaques form
Periodic loss of neurological function and progressive disability
Term
What is the most common form of MS?
Definition
relapsing remitting
Periodic loss of neurological function
Term
What are plaques?
Definition
Inflammation and scar tissue that forms where myelin is lost in multiple areas
Term
What are MS symptoms that worsen during an increase in body temperature known as?
Definition
Uhthoff's phenomena
Term
T/F in Classic MS neutrophils will be present in the CSF.
Definition
FALSE
lymphocytes may be present but never neutrophils
Term
On MRI of the brain with gadolinium what allows it to enter the brain parenchyma?
Definition
active inflammation and breakdown of the blood brain barrier, showing a new MS plaque
Term
Diagnostic Criteria for Multiple Sclerosis
Definition
-Clinical Evidence for Lesions that reflect white matter dysfunction in expected age range
-Objective abnormalities on neuro exam
-Lesion must fit into 1 of the following:
1. 2 Episodes >24hrs seperated by 1 month
2. Slow progressive deterioration over 6 months
-Diagnosis made by skilled MD
-No better explanation
Term
What is used to stain normal myelin?
Definition
Luxol fast blue
Term
What types of cells can be found at the edge of a plague?
Definition
Inflammatory response
T-cells
B-Cells
Macrophages
Midroglia
Term
What triggers the symptoms of MS?
Definition
inflammation-> Demyelination-> Axonal Loss
Term
What is the role of TH1 cells in the MS immune response?
Definition
Activiated in systemic circulation and cross BBB.
Stimulate B-cells to make Ab
Stimulate Macrophages to make substances that demyelinate or cause axonal damage
Term
What is the role of TH2 cells in the MS immune response?
Definition
Regulate the process and reduce the pro-inflammatory response of the TH1 cells
Term
What do Macrophages produce that can demyelinate?
Definition
TNF alpha
O2
NO
Term
What are the 2 categories of MS?
Definition
Relapsing
Progressive
Term
What are Relapsing Forms of MS?
Definition
Exacerbations followed by complete or incomplete recovery
Slow, inconsistent accumulation of disability occurs in the majority of patients
Term
How is the progressive form of MS defined?
Definition
Steady progression of disability with few or no exacerbations
Term
What is the gender distribution in primary progressive MS?
Definition
equal Male to Female
Term
Symptoms of MS
Definition
Weakness, Numbness, Fatigue, vision problems, slurred speech, poor coordination, short-term memory loss, depression, bladder and bowel dysfunction, partial or complete paralysis
Term
What are 4 common demyelinating syndromes?
Definition
Optic Neuritis
Myelitis
Brainstem
Cerebellum
Term
What are the symptoms of demyelinating Brainstem syndromes?
Definition
Oculomotor
Trigeminal neuralgia, Hemifacial spasm, Bell's Palsy
Vestibulopathy and other cranial neuropathies
Term
What are the symptoms of cerebellar demyelinating syndromes?
Definition
Acute ataxia
tremor
eye movement abnormalities
Term
How is MS Diagnosed?
Definition
MRI Scan (Gadolinium enhanced)
Spinal Tap
-Elevated Myelin Basic Protein
-oligoclonal Banding
Evoked Potential
Term
What are the markers for MS in the CSF?
Definition
Increased IgG index
Presence of oligoclonal bands
Term
How does Evoked response assist in diagnosing MS?
Definition
If the optic nerve is demyelinated from MS, there will be a delay of the P100 or complete absence of it.
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