Chapter 23 MS

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CNS progressive demyelinated disorder

MS
Is the peripheral nervous system involved in MS

no
What gender is more affected by MS

women
What is the normal age to be diagnoised with MS

20-40
What race is primarily affected by MS

caucasians
What is the etiology of MS

idiopathic
What have epidemiologist discovered

viral illness in teens & genetic predisposition

prevalent farther from equator

uncommon in tropics

not inherited,but family predisposition
What cell produces myelin in the CNS

oligodendrocytes
What is the patho of MS

nerve fibers in the white brain matter, spine, and optic nerves demyelinate

lesions of plaque form
How are the plaque lesions formed
- immune-mediated inflammatory response
- lymphs invade CNS
- Killer T cells & Macs help damage oligodendrocytes
- B cells migrate to CNS during inflammation
- B Cells trapped after inflammation stops
- proliferate into plasma cells
- secreate IgG
- IgG found in CSF
- IgG composed of oligoclonal bands
Is MS an autoimmune disorder

yes
What is not found in the serum
indicates immunological acitivy in the brain
and is useful in the diagnosis of MS

CSF oligoclonal IgG
What happens to CNS with each exacerbation of MS
- more areas of the CNS are involved
- eventually degenertaion becomes irreversable
What are the signs of MS
- optic neuritis
- diplopia
- blurred vision
- scotoma
- nystagmus
- parathesias
- fatigue
- muscular weakness
- unsteady gait
- hyperreflexia
- paraplegia/quadraplegia
- sphincter abnormalities
- dysphagia
- speech problems
- dysarthria
- heat intolerance
- emotional disturbances
What is optic neuritis

unilateral visual impairment from clouding, blurry, or complete vision loss
What is diplopia

double vision
What is a scotoma

a spot in the vision field
involuntary movement of the eye in all directions

nystagmus
loss of the sensation of touch accompanied by tingling or burning to the face and extremities

parathesias
What is the rationale behind muscle weakness in MS

related to the plauqes forming on the corticospinal tract
What causes paraplegia or quadriplegia in MS

plauqes and edema blocking transmission to the spinal cord
Why would speech problems occur in a patient with MS

impairment of tounge or other speech muscles
What is dysarthria

poor articulation
What effect can heat have on individuals with MS

worsen signs and symptoms
What is the rationale behind the emotional outbursts associated with MS

plauqes on the temporal and frontal lobes
What are the diagnostic test used for MS
- H&P
- MRI
- CT
- CSF
- Evoked response studies
What is the CSF examined for when checking for MS

elevated oligoclonal IgG
What are evoked respopnse studies

electrophysiologically showing delays to stimuli in unmylienated axons
What are the complications of MS
- progressive and chronic disability
- paralysis
- respiratory infection
- cystitis/kidney infection
- death
Why is repiratory infection a possible complication of MS

impaired ventilation
Why would a person with MS get cystitis
- urinary incontinence leads to urinary stasis
- causing an infection
What will normally cause the death of a patient with MS

infection
What are the treatments for a patient with MS
- Pallative
- steroids
- interferon
- physical therapy
- healthy outlook
Why are steroids given to a patient with MS
- mainstay for acute relapse
- reduce inflammation
- improve nerve condition
- reduce exabcerbations
What is always a concern when prescribing corticosteroids to a patient

side effects
How does interferon treatment work in MS
- cytokine prevents viral replication
- decreases antibody formation
- antibodies not there to attack mylein sheath
Why is physical therapy done for patients with MS

maintain mucscle tone
What is the prognosis for MS

unpredictable
Which MS patients have a worse prognosis

onset after 40 or early motor disability development early in the course of the disease

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Chapter 23 MS

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Chapter 23 MS

Updated

2012-06-01T12:33:58Z