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6 Cards in this Set
- Front
- Back
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Multiple Sclerosis
- Clinical sx |
- CN: intranuclear opthalmoplegia (often b/lat); optic atrophy, reduced visual acuity, reduced visual acuity, and any other CN palsy
- PNS: UMN spasticity, weakness, brisk reflexes and altered sensation - Cerebellar: DANISH - Higher mental fx: depression, occasional euphoria - Autonomic: urinary retention/incontinence, impotence and bowel problems |
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Multiple Sclerosis
- Dx |
CNS demyelination (plaques) causing neurological impairment that is disseminated in both time and space
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Multiple Sclerosis
- Cause |
- Unknown but both genetic (HLA-DR2; IL-2 and IL-7 receptors); environmental factors (latitude, epstein-barr)
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Multiple Sclerosis
- Ix |
CSF: oligoclonal IgG bands
MRI: periventricular white matter plaques Visual evoked potentials: delayed velocity but normal amplitude (evidence of previous optic neuritis) |
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Multiple Sclerosis
- Tx |
- PT, OT, social work + physician
- DMARDs: interferon and glatiramer reduce relapse rate (don’t affect progression); monoclonal antibody reduce progression and disability e.g. rituximab - Symptomatic tx: methyl-pred during acute phase may shorten duration - Anti-spasmodics (baclofen) - Carbamazepine (neuropathic pain) - Laxatives and intermittent catheterisation/oxybutynin for bowel and bladder disturbance |
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Impairment vs disability vs handicap
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Impairment is arm paralysis
Disability is inability to write Handicap is inability to work as accountant |
