Multiple Sclerosis

Degenerative disease of the CNS that affects multiple parts of the brain and spinal chord

in regards to where the plaques are
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Degenerative disease of the CNS that affects multiple parts of the brain and spinal chord

in regards to where the plaques are
What is MS?
15-45 y/o
- peak diagnosis during late 20s / early 30s

Women are twice as likely to get it
Peak incidence:
Age
Geography (rates are higher the farther north of the equator you go)
Genetics
Environment
What are the risk factors for MS?
HLA-DR2

Epstein Barr Virus
Smoking
Vitamin D Deficiency
MS has Association with what gene?

Most common environmental factors?
an autoimmune disorder
The pathophysiology of MS is that it is....
Demyelination
- stripping of the myelin sheath which causes disruption in transmission of nerve impulses
What is the main pathophysiological cause?
the axon and increases production speed

Demyelination = slower impulses and axon is exposed and lost (irreversible)
The myelin sheath protects....
Inflammation --> Demyelination --> Axon loss
What is the brief summary of pathophysiology?
Primary - direct consequence (visual / Gait / weakness)

Secondary - Consequences from primary symptoms (Infections, poor nutrition)

Tertiary - QOL (financial problems, social problems)
What are the categories of clinical presentation?
EDSS

MSFC
Tools used to assess disease progression?
Score of ≤ 3What is the goal EDSS?Most common form Acute worsening with periods of complete remission No disease progression during thisWhat is RRMS?Steadily worsening disease Remissions do happen but they are incomplete so there is some disease progressionWhat is SPMS?Slow but continuous worsening No remissions or relapsesWhat is PPMS?STEADILY worsening with relapses and remitting RRMS and PPMSWhat is PRMS?infections heat sleep deprivation stress malnutrition..etcWhat things can cause relapses?MS does not directly increase mortality It comes from secondary complications (infections, pneumonia..etc) Suicide rates are 7x higherHow is mortality related to MS?Clinically isolated syndrome MRI***What is needed to diagnose MS?