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45 Cards in this Set
- Front
- Back
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What are the 5 most common neuropsychological deficits in MS? |
1. PROCESSING SPEED 2. Working memory 3. RECENT Memory (particularly EPISODIC) 4. Abstract reasoning/Problem solving 5. Inattention |
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What neuropsychological deficit is thought to underlie all cognitive problems in MS? |
Slowed processing speed. |
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What are the 4 types/courses of MS? |
1. Relapsing Remitting 2. Primary Progressive 3. Secondary Progressive 4. Progressive Relapsing |
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What is Progressive Relapsing MS?
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Progressive decline from initial onset, with acute relapses, but the period between relapses is progressively worse
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How is relapsing remitting MS different from Progressive Relapsing MS? |
Relapsing Remitting includes a return to BASELINE. |
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What percentage of MS patients eventually develop secondary progressive MS? |
80% |
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What course of MS is associated with the worse outcome? |
Both the Progressive Types. |
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What course of MS is associated with WORST COGNITIVE FUNCTIONING? |
Secondary progressive |
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What percentage of all MS patients have cognitive dysfunction? |
50% |
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What causes MS? |
T-Cells (Lymphocytes) getting trapped behind the blood brain barrier and attacking oligodendrocytes |
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What are the most common INITIAL presentations of MS?
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Sensory disturbance in the limbs
Visual loss
SUBACUTE Motor disturbance |
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What is L'hermitte's sign? |
When people with MS feel a shock in the back and limbs when they bend their neck |
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What are common sensory disturbances in the limbs for MS? |
Parasthesias L' hermitte's sign Numbness in one or more limbs |
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What common visual disturbances exist in MS? |
Monocular visual loss
OPTIC NEURITIS (i.e., inflammation of optic nerve)
Opthalamoplegia (i.e., weakness in occular muscles)
Diplopia
Visual acuity reduction |
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What are common MS-related motor disturbances? |
Gait difficulties
Weakness
Limb ataxia
Slurred speech
Dysphagia
Balance problems
Urinary incontinence
Spasticity
Paresis
Sexual dysfunction |
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What are the top three INITIAL PRESENTING SYMPTOMS of MS (in order)? |
1. Sensory disturbance in the LIMBS 2. Visual loss 3. Motor disturbance (subacute) |
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What is the average age of onset for MS? |
Ages 20-40 |
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Who has more MS, Whites or minorities, girls or boys? |
Whites Girls by 3:1 |
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Who has worse cognitive functioning in MS, Whites or minorities, girls or boys? |
Minorities Boys |
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What is the most common type of MS?
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Relapsing remitting |
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What is benign MS? |
MS in which people remain fully functional 15 years after diagnosis. |
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Are there genetic factors involved with MS? |
Yes. First-degree relatives have a 2-5% greater chance of getting MS than the general population's 0.1% chance. |
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What type of RECENT MEMORY is most affected in MS? |
Episodic and explicit (e.g., remembering what show you watched last night) |
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How many MS patients report memory decline? |
40-60% |
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Is there a relationship with disease duration and cognitive decline? |
Yes. |
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What types of memory is less affected in MS? |
Semantic Autobiographical Implicit |
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What strategy can be used to improve memory in MS? |
Slow down the presentation of stimuli. |
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What is the rate of unemployment in MS 5 years after diagnosis?
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80%
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What symptoms are most associated with unemployment in MS? |
Fatigue Cognitive dysfunction |
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What is the most common symptom out of them all that is reported most often over the ENTIRE COURSE (not just initial onset) of MS? |
Fatigue |
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Are disease modifying medications in MS associated with cognitive problems? |
Nope. |
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_______ worsens fatigue in MS, and _________ worsens depression in MS. |
Sleep disturbance; Chronic Pain |
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What psychiatric problem has a lifetime prevalence of 50% in MS? |
Depression |
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What aspects of MS are most associated with depression in MS? |
Brain lesions Psychosocial issues BUT NOT PHYSICAL DISABILITY |
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Is mood in MS treatable? |
YES. They respond to both antidepressants and CBT. |
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What MRI T2 findings are most associated with cognitive dysfunction in MS? |
Lesion load
3rd Ventricle Dilation Thalamic and Cortical Atrophy |
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Is cognitive function used to diagnose MS? |
Nope. |
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What percentage of MS patients will have an average life expectancy? |
90-95% |
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Do people with a younger age of onset have a better or worse course of MS? |
Better. Progression is slower with younger diagnosis. |
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What are the diagnostic criteria for MS? |
1. 2 or more attacks with positive MRI findings 2. Dissemination of lesions on T2 imaging |
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What percenage of MS patients present with relapsing remitting course? |
85% |
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How long does it take relapsing remitting MS to convert to secondary progressive? |
10-15 years |
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TRUE or FALSE: More boys than girls have MS in the under age 6 group. |
True |
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What is the most common course of MS in pediatric cases? |
Relapsing remitting |
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What is the best treatment for cognitive dysfunction in MS? |
Amphetamines |
