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10 Cards in this Set
- Front
- Back
Acute disseminated encephalomyelitis: ADEM
-Timing -What age group -Extent of involvement -CSF findings |
-Single episode, but can be reccurent
-usually in children -large areas of involvement -accompianed by inflammatory CSF |
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Multiple Sclerosis
-Definition? -What cellular components are damaged and when? -When is treatment effective? |
-Spectrum of chronic, usually progressive, immune mediated CNS disease, w/or w/o acute worsening. Decent "recovery" within six months
-Demyelination and axonal loss. Axonal damage and brain atrophy occur ??early/late?? and are irreversible -Early treatment is effective to prevent axonal loss and brain atrophy |
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Multiple Sclerosis Epidemiology
-Environmental Agent? -Genetics? -Geography? -Sex? -Age of Onset? |
-Inconclusive evidence of viruses, mercury exposure, or vitamin D deficiency
-High MZ twin concordance indicates genetic component -Prevalent in north northern hemisphere except Asians, Native Americans, and Lapps. -2 female: 1 male -Onset between age 25-35; mean of 30 |
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Multiple Sclerosis Symptoms
-Most symptomatic organs? -Disabling features? -Temperature? |
-Optic nerves and spinal cord are most symptomatic
-Thus visual and ambulation difficulties are the major disabling features -Odd sensitivy to high temperatures |
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3 Classifications of Multiple Sclerosis
-Key features of each |
*Monosymptomatic demyelination isn't MS, but can predispose to it.
1) Relapsing Remitting -can become S.P. 2) Secondary Progressive -w/ or w/o relapses 3) Primary Progressive -No periods of recovery -Non inflammatory thus most treatments are ineffective |
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Optic Neuritis Component
-Visual or pain symptoms? -Appearance of retina? -Test? |
*Monocular loss of Vision
-Pain -Optic swelling followed by atrophy: optic disk appears white -Prolonged Visual Evoked Responses (VERs) in the primary visual cortex EEG can be seen in a pattern reversal test. |
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Symptom of MLF dysfunction in MS?
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INO: internuclear opthalmoplegia
-Loss of adduction of the ipsilateral eye and end-point abduction nystagmus in the contralateral eye when looking away from the affected side. |
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Oligoclonal bands in MS
-In CSF and/or plasma? |
-Oligoclonal bands in the CSF but NOT in the plasma indicate IgG production within the CNS
-Bands in both CSF and plasma indicate an infection such as lyme or HIV. |
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Spinal components of MS
-3 Typical compaints |
1) Sensory: parasthesias, loss of sensation, pain
2) Ambulatory difficulties 3) loss of upper limb coordination |
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3 Types of Plaques/Lesions in MS
-Process indicated by each -How to image each 1) Acute 2) Chronic 3) Black Hole |
??Where does Gadallinium fit??
1) Acute -inflammation/edema -seen ???? 2) Chronic -Demyelination -??? 3) Black Hole -Axonal Loss -??? |