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20 Cards in this Set
- Front
- Back
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Acquired demyelinating disease examples:
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MS, Neuromelitis optica, Acute disseminated encephalomelitis (ADEM), Encephalomyelitis
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Most common chronic CNS disease of young adults in the USA?
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MS
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Average age of MS onset
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3rd decade
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Diagnosis of MS
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Presentation: optic neuritis, transvers myelitis, opthalmoplegia, paresthesia,
MRI |
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Risk factors of MS
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Familial
Northern (temperate) zones |
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Pathogenesis of MS
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CD4+ TH1 and TH17 self reactive to myelin --> plaques
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Where are the MS plaques?
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periventricular white mater
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CSF findings with MS?
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IgG
oligoclonal bands (on EP) elevated protein moderate pleocytosis in 1/3 of cases |
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Neuromelitis Optica (Devic Disease) CSF results?
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Leukocytes (including PMNs) opposed to MS
Necrosis in the brain (unlike MS) immunoglobulin and compliment |
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Acute Disseminated Encephalomyelitis (ADEM) progression pattern
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acute
monophasic (all a the same stage unlike MS) |
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Acute Disseminated Encephalomyelitis (ADEM) causes of onset?
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following viral immunization for MMR, smallpox, or rabies
but more often after measles |
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Acute Disseminated Encephalomyelitis (ADEM) progression
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diffuse monophasic, single episode, 50% recover completely, 20% die
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Clinical symptoms of Acute Disseminated Encephalomyelitis (ADEM).
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headache, lethargy, nausea/vom, seizures, coma
no focal findings (unlike MS) |
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cause of Acute Necrotizing Hemorrhagic Encephalomyelitis (ANHE)
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follows upper respiratory infection
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Clinical progression of Acute Necrotizing Hemorrhagic Encephalomyelitis (ANHE)
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rapid onset of weakenss, seizures, and coma, often fatal or with major deficits
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Histopathology of ADEM?
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gray discoloration of white-matter vessels
demyelination with preserved axons |
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Histopathology of ANHE?
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widespread demyeliation throughout CNS
destruction includes small blood vessels white and gray matter |
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Clinical signs of Central Pontine Myelinolysis?
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symmetric pattern involving basis pontis and pontine tegmentum
associated with hyponatremia correction |
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cause of Central pontine meylinolysis?
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rapid correction of hyponatremia
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morphology of Central Pontine Myelinolysis
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myelin loss without evidence of inflammation
same stage of myelin loss |
