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10 Cards in this Set

  • Front
  • Back
Acute disseminated encephalomyelitis: ADEM
-Timing
-What age group
-Extent of involvement
-CSF findings
-Single episode, but can be reccurent
-usually in children
-large areas of involvement
-accompianed by inflammatory CSF
Multiple Sclerosis
-Definition?
-What cellular components are damaged and when?
-When is treatment effective?
-Spectrum of chronic, usually progressive, immune mediated CNS disease, w/or w/o acute worsening. Decent "recovery" within six months

-Demyelination and axonal loss. Axonal damage and brain atrophy occur ??early/late?? and are irreversible

-Early treatment is effective to prevent axonal loss and brain atrophy
Multiple Sclerosis Epidemiology
-Environmental Agent?
-Genetics?
-Geography?
-Sex?
-Age of Onset?
-Inconclusive evidence of viruses, mercury exposure, or vitamin D deficiency

-High MZ twin concordance indicates genetic component

-Prevalent in north northern hemisphere except Asians, Native Americans, and Lapps.

-2 female: 1 male

-Onset between age 25-35; mean of 30
Multiple Sclerosis Symptoms
-Most symptomatic organs?
-Disabling features?
-Temperature?
-Optic nerves and spinal cord are most symptomatic

-Thus visual and ambulation difficulties are the major disabling features

-Odd sensitivy to high temperatures
3 Classifications of Multiple Sclerosis
-Key features of each
*Monosymptomatic demyelination isn't MS, but can predispose to it.

1) Relapsing Remitting
-can become S.P.

2) Secondary Progressive
-w/ or w/o relapses

3) Primary Progressive
-No periods of recovery
-Non inflammatory thus most treatments are ineffective
Optic Neuritis Component
-Visual or pain symptoms?
-Appearance of retina?
-Test?
*Monocular loss of Vision
-Pain
-Optic swelling followed by atrophy: optic disk appears white
-Prolonged Visual Evoked Responses (VERs) in the primary visual cortex EEG can be seen in a pattern reversal test.
Symptom of MLF dysfunction in MS?
INO: internuclear opthalmoplegia

-Loss of adduction of the ipsilateral eye and end-point abduction nystagmus in the contralateral eye when looking away from the affected side.
Oligoclonal bands in MS
-In CSF and/or plasma?
-Oligoclonal bands in the CSF but NOT in the plasma indicate IgG production within the CNS

-Bands in both CSF and plasma indicate an infection such as lyme or HIV.
Spinal components of MS
-3 Typical compaints
1) Sensory: parasthesias, loss of sensation, pain

2) Ambulatory difficulties

3) loss of upper limb coordination
3 Types of Plaques/Lesions in MS
-Process indicated by each
-How to image each
1) Acute
2) Chronic
3) Black Hole
??Where does Gadallinium fit??

1) Acute
-inflammation/edema
-seen ????

2) Chronic
-Demyelination
-???

3) Black Hole
-Axonal Loss
-???