Neuro-Ics-Ms

Front 1

gold std to Dx MS

Back 1

clinical assessment

Front 2

what's wrong in MS

Back 2

multiple exacerbations d/t lesions affecting CNS white matter (demyelination in CNS)

Front 3

-2 attacks
-clinical evidence of 2 lesions

Back 3

Clinically Definite MS

Front 4

-2 attacks
-clinical evidence of 1 lesion

Back 4

if MRI shows typical WM (white matter) lesions
-->Clinically Definite MS

if not
-->Clinically Probable MS

Front 5

-1 attack
-clinical evidence of 1 lesion

Back 5

if MRI shows typical WM lesions
-->Clinically Probable MS

if not
-->not diagnostic

Front 6

-1 attack
-clinical evidence of one lesion plus oligoclonal bands in CSF

Back 6

if MRI shows typical WM (white matter) lesions
-->Laboratory Supported Definite MS

if not
-->not diagnostic

Front 7

who is more likely to develop MS?

Back 7

-women
-northern latitudes

Front 8

what contributes to the development of clinically symptomatic MS?

Back 8

-genes (certain MHC types)
-hormones
-infectious exposure
-environ

Front 9

Sx of MS

Back 9

Disturbance of sensation, gait, and vision (monocular visual loss)

-optic neuritis (blurry vision)
-intranuclear opthalmoplegia (esp if bilateral; Goljan--look left, left eye has nystagmus (jerks) and right eye still stares at you, *pathognomonic for MS!)
-unusual sensory Sx: i.e. feel like a bruise but nothing is there
-L'hermitte's phenomenon (damage to posterior columns: fasciculus gracilis/cuneatus) in absence of cervical trauma
-Bladder/bowel dysfxn

Front 10

Disease Course of MS

Back 10

benign MS (15%)
relapsing-remitting (60%),
relapsing-progressive(25%)
chronic-progressive (15%)

40% pts with intiial attacks render them non-ambulatory and may not recover

Front 11

relapse rate of MS

Back 11

0.5-1.0 MS exacerbation per year (1 every other year)

Front 12

favorable prognostic factors within the first two years of MS:

Back 12

1.female
2.relapsing-remitting course
3.optic or sensory symptoms (weird)
4.young age at onset (weird)
5.few exacerbations in first two years

Front 13

clues that lead to doubt for Dx of MS

Back 13

1.no eye findings
2.no remissions
3.localized Dz
4.no CSF abnormalities
5.no brain MRI abnormalities
6.atypical clinical features like prominent cortical involvement

Front 14

purpose of CSF and MRI in Dx MS

Back 14

to exclude other dz

Front 15

CSF in CP

Back 15

unique CSF oligoclonal IgG: increased IgG synthesis within CSF compartment

Front 16

BBB damage in CF?

Back 16

no

Front 17

CSF counts in MS

Back 17

<50 cells/microliter

Front 18

MRI results in MS

Back 18

multiple periventricular white matter lesions
-little correlations b/w lesion load and disability

Front 19

probability of new lesions vs. relapse in MS?

Back 19

new lesions develop up to 10 times more frequently than clinical relapse

Front 20

Tx for MS

Back 20

-Glucocorticoids-does not change natural Hx of Dx
-methotrexate: for chronic progressive dz

Front 21

Tx chronic progessive MS

Back 21

Methotrexate