Multiple Sclerosis

Question 1

Who is MS MC in?

Answer 1

Young adult whilte females (12-50yo)

Question 2

Where is MS MC?

Answer 2

Northern latitude & greater the farther from the equator

Question 3

How do 70% of MS pts begin?

Answer 3

Relapsing-remitting MS

Question 4

What is the duration of exacerbations or relapses?

Answer 4

Always >24 hours & average wks to mo & then spon gradually improve or resolve

Question 5

How many exacerbations do new pt experience in the 1st year?

Answer 5

1-3

Question 6

What do subsequent exacerbations usually implicate?

Answer 6

Different area of CNS disturbance

Question 7

How can an exacerbation present?

Answer 7

Acute or subacute

Question 8

What are the MC presenting exacerbations in MS?

Answer 8

• Parasthesia, us unilateral
• Optic neuritis
• Transverse Myelitis (LC than paraparesis)
• Vertigo
• Diplopia
• Ataxia
• Facial pain

Question 9

What is Optic neuritis?

Answer 9

Monocular visual decrease

Question 10

What is Transverse Myelitis?

Answer 10

Focal weakness at 1 limb or 1 side

Question 11

What is the sensory disturbance distribution?

Answer 11

Usually not in distribution of a peripheral nerve

Question 12

What is the weakness type?

Answer 12

UMN type & never of a single muscle

Question 13

What is the cause of monocular visual decrease?

Answer 13

Retro-orbital

Optic disc may be inflamed

Question 14

What is the most sensitive imaging for MS?

Answer 14

MRI w/ & w/o contrast

Question 15

Where are MS plaques found?

Answer 15

Anywhere in the white matter of bain or myelinated SC

Question 16

The ____ ____ is unaffected by MS.

Answer 16

Peripheral nervous system

Question 17

____ ____ occur in~90% & once + remain in the ___.

Answer 17

CSF ABN

Pons

Question 18

What are the CSF ABN of MS?

Answer 18

• • Oligoclonal bands
• • IgG index
• • IgG synthesis rate

Question 19

What is MS?

Answer 19

AI dz that targets the oligodendrocyte

Question 20

What are the dz modifying drugs?

Answer 20

• Beta-interferons
• Glatiramer acetate (Copaxone)
• Anti-monoclonal Ab agents natalizumab (Tysabri)
• Fingolimod
• Mitoxantrone (2ndary progressive MS)

Question 21

What is the management of MS?

Answer 21

• Corticosteroids
• Antispastic agents
• Agents for bladder spasticity
• Antidepressants

Question 22

What are corticosteroids used for?

Answer 22

Shorten length of exacerbations