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15 Cards in this Set
- Front
- Back
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Demyelinating vs Dysmyelinating Disease
Example of each |
Demyelinating: destruction of previously normal myelin (MS)
Dysmyelinating: myelin is improperly formed (leukodystrophies) |
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What ethnic groups are most at risk for MS? Least at risk?
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Most: Northern Europeans
Least: Jap, Chin, African American None: Eskimo, Bantu, Yaku Between latitudes 40 and 60 (low sunlight) |
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What origin of MS does its geographic distribution suggest?
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Environmental or Viral Origin
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What evidence supports an autoimmune pathogenesis for MS?
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Female predominance
Age of onset Relapsing and remitting nature Protective effect of pregnancy |
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What is the current theory of MS onset?
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Viral infection promotes entry of T cells and antibodies into CNS
Increased CAM (cell adhesion molecs) and cytokines ECM breaks down to assist migration of immune response factors/cells Autoimmune response activated against Antigens Immune attack on myelin Leaves scar tissue and plaques over white matter, cerebellum, BS, SC, optic nerves (multiple sclerosis) |
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What are the initial symptoms of MS?
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Focal weakness, numbness, tingling, unsteadiness
Sudden loss or blurring of vision SC syndrome with paraparesis, leg numbness |
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What is the classic diagnosis of MS?
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Distinct events involving distinct areas of the CNS at distinct moments in time
"Separated by time and space |
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Ïf a pt has 2 attacks and 2 clinical lesions, what supporting data is needed for MS diagnosis?
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None
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If a pt has 2 attacks and 1 clinical lesion, what supporting data is needed for MS diagnosis?
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MRI or positive CSF
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What findings upon CSF examination would correlate with MS?
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mild lymphocytosis, elevated protein, elevated IgG
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If a pt has 1 attack and 2 clinical lesions, what supporting data is needed for MS diagnosis?
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MRI or second attack
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Effect of corticosteroids on MS
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Hastens recovery from acute relapse but don't affect prognosis
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Effect of beta interferon therapy on MS
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beta interferon (Avenox, Betaseron) act as immunomodulatory agents to reduce the rate of relapse. Act to delay disability, reduce severity of syx, slow progression of dz
(Glatiramer acetate --Copaxone-- does same thing) |
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Optic Neuritis and __________ occur as symptomatic events in patients with MS
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Transverse myelitis
But some pts who present with these syx never have other syx |
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ADEM vs MS
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ADEM = acute disseminated encephalomyelitis; monophasic illness in association with viral infection or vaccination (measles, chickenpox), diffuse motor sensory deficits; tx w/corticosteroids, IV immunoglobulins
MS: multiphasic |
