multiple sclerosis

Andrea B
Mind Map by Andrea B, updated more than 1 year ago
Andrea B
Created by Andrea B over 3 years ago
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Description

Neuroimmunology lecture: Multiple Sclerosis

Resource summary

multiple sclerosis
1 Chronic Auto immune disease of the CNS
1.1 Inflammation
1.2 demyelination
1.3 axonal degeneration
2 symptoms of MS
2.1 common
2.1.1 vision problems-fatigue-parasthesis

Annotations:

  • paresthesia-pins and needles
2.1.2 bladder/bowel/sexual dysfunction
2.1.3 Gait problem-spasticity

Annotations:

  • gait-walking problem
2.1.4 pain-depression-cognitive dysfunction
2.2 less common
2.2.1 headache-hearing loss
2.2.2 itching-seizures-speech/swall. difficulties
3 slow progression characterized:
3.1 disseminated patches of demyelination in brain and SC
3.2 neurological symptoms and signs
3.3 classical remissions and exacerbations
4 chronic inflammation (scarring)
4.1 MS lesions disseminated in time and space
5 likely triggered by environmental expo in genetically susceptible host
5.1 environmental factors
5.1.1 viruses:epstein barr virus
5.1.2 insufficient expo to mild infections early life
5.1.3 low sun expo/low Vita D levels
5.1.3.1 pathway UV radiation induced immunnosupression
5.1.3.1.1 UVR-Vita D synthesis-Th1 have Vita D receptors
5.1.3.1.1.1 activation of these receptors reduces immune activity INVITRO
5.1.3.1.2 UVR-immunosupress-subepidermal
5.1.3.1.2.1 cytokine signaling & other mech. does not involve VitaD
5.1.4 smoking
6 MS genetics
6.1 Risk .02% of pop.
7 Potential triggers
7.1 infectious agent
7.2 genetic predisposition
7.3 environmental factors
8 An MS "Attack"
8.1 change in neurological function more than 24 hrs
8.2 episode last avg. 3-6 wks
8.2.1 length of episode decreased w/ steroid treatment
8.3 Not MS attack
8.3.1 change neurolog. due to infection/fever

Annotations:

  • most common infections are UTIs/URIs -experience uhthoff's phenomenon-which is recurrence/worsening of prior MS symptoms secondary to elevation in for body temp. Mechanism: chronic demyelination W transient slowing of conduction
9 How is MS diagnosed?
9.1 Dissemination in Space & Time

Annotations:

  • diagnostic criteria for MS (spread over)
9.1.1 T2 lesions in at least 2 of 4 areas of CNS
9.1.1.1 periventricular
9.1.1.1.1 "classic"periventricular shape
9.1.1.1.2 ovoid or dawsons finger
9.1.1.1.3 rep-inflammation around medullary veins (outward ventricles
9.1.1.2 juxacortical( subcortical)
9.1.1.2.1 U shaped white matter deep to cortex
9.1.1.3 brainstem/cerebellum
9.1.1.3.1 Infratentorial (aka)
9.1.1.4 spinal cord
9.1.1.4.1 one segment or less of SC
9.1.1.4.2 usually dorsal or lateral location
9.2 DIT Demonstrated by
9.2.1 T2 lesion & follow up MRI
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