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Neuro II Exam 1 - MS
Multiple Sclerosis
25
Health Care
Graduate
10/09/2012

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Cards

Term
Peak onset
Definition
20-30 yo
Term
Gender prevalence
Definition
F > M
(1.4-3.1x more likely)
Term
Incidence 20x _____ in 1st gen relatives
Definition
higher
Term
MS = Autoimmune reaction attacking ______
Definition
myelin/oligodendrocytes
Term
Most frequent sites of plaques (4)
Definition
optic nerves
brainstem
cerebellum
spinal cord
Term
Demyelination by direct & indirect mechanisms
Definition
Direct: antibody-mediated/cell-mediated immunity
Indirect: secretion of lymphokines/cytokines
Term
Ultrastructural characteristics of plaques (4)
Definition
1. separation of outer lamellae
2. degeneration in myelin
3. phagocytosis of myelin
4. preservation of axons
Term
"Nerve fiber fatigue"
Definition
more energy required to conduct nerve impulse
Term
Criteria for MS dx (5)
Definition
medical hx
neuro exam
evoked potentials
MRI
lumbar puncture
Term
Signs of "definite" MS (4)
Definition
≥2 bouts separated by ≥1 mo OR progressive for ≥6 mos
neurologic signs in ≥1 fxnl system of CNS
onset at 10-50 yo
absence of other explanation
Term
Signs of "probable" MS (5)
Definition
hx of relapsing/remitting s/sx
only one current sign
single bout of symptoms
good recovery >> variable s/sx
absence of other explanation
Term
Signs of "possible" MS (3)
Definition
hx of relapsing/remitting s/sx
no documentation of signs for ≥1 lesion
absence of other explanation
Term
CSF results confirming demyelination (3)
Definition
incr in immunoglobulin concentrations
incr protein level
incr cell count (1º T-lymphocytes)
Term
MS categories (4)
Definition
relapsing-remitting (85%),
primary progressive,
secondary progressive,
progressive-relapsing
Term
Relapsing-Remitting MS
Definition
relapses with recovery; remissions show no visible disease progression
Term
Primary Progressive MS
Definition
continued progression from onset, without remissions/plateaus
Term
Secondary Progressive MS
Definition
relapsing-remitting >> progression at variable rate
Term
Progressive-Relapsing MS
Definition
progressive from onset, with clear relapses
Term
Early s/sx (9)
Definition
fatigue,
diplopia,
blurred vision,
weakness,
sensory changes (ascending numbness),
intention tremor,
bladder control probs,
incoordination,
heat intolerance
Term
Diplopia 2º to:
Definition
"internuclear opthalmoplegia" (lesion in MLF)
Term
Greatest sensation loss in MS pt is usually:
Definition
dorsal column info (>spinothalamic)
Term
Later s/sx (6)
Definition
increased weakness/spasticity,
cerebellar ataxia,
scanning speech (overshoot speaking, decr prosody)
Lhermitte's sign,
incr numbness,
emotional lability
Term
Unfavorable prognostic signs (5)
Definition
initially progressive course
male
high EDSS scores
fxnl systems involved
incr motor system deficits
Term
Favorable prognostic signs (5)
Definition
onset before 30 yo
female
complete recoveries during remission
sensory system involvement
longer initial remission
Term
Medical management (3)
Definition
Treat relapses (immunosuppression c corticosteroids)
Prevent relapses (Interferon)
Address spasticity (Baclofen, Dantrolene, Diazepam)
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