Multiple Sclerosis Features and Mechanisms
- More Common in Women
- Presents in 20's and 30's
- Northern Europeans
- Unknown mechanism, genetic factor
- HLA-DRB1
- Autoimmune Demyelination of CNS
- White Matter of Brain and Spinal Cord
- T Cell Mediated Inflammation
Multiple Sclerosis Symptoms and Diagnosis
- Optic Neuritis
- Internuclear Ophthalmoplegia
- Scanning Speech
- Urinary and Fecal Incontinence
- Motor Issues (Intention Tremor, Paresis)
- Numbness and Pain
- Depression
- Relapsing Symptoms
- Gold Standard = Plaques on MRI
- Increased CSF Immunoglobulins (IgG)
- Oligoclonal Bands
Multiple Sclerosis Interventions
- Corticosteroids
- Interferon Beta
- Dimethyl Fumarate (Tecfidera)
- Fingolimod (Gilenya)
- Mitoxantrone (Novantrone)
- Natalizumab (Tysabri)
- Increase Exercise
- Identify Triggers
Vitamin B12 (Cobalamin) Mechanism and Deficiency
- Cobalamin
- Large reserve pool in the liver
- Homocysteine to methionine
- Methylmalonyl CoA to succinyl CoA
- Macrocytic Megaloblastic Anemia
- Hypersegmented Neutrophils
- Neurologic defects
- Posterior column
- Lateral corticospinal tract
- Spinocerebellar tract
Metachromatic Leukodystrophy
- Autosomal Recessive
- Arylsulfatase A Deficiency
- Increased Cerebroside Sulfate
- Demyelination
- Ataxia
- Dementia
Guillain-Barre Syndrome Assessment
- Ascending Paralysis
- Muscle Weakness
- Paresthesias (Pins and Needles)
- Diplopia
- Difficulty Speaking
- Dysphagia
- Labile Blood Pressure
- Loss of Bowel and Bladder Control
- Aggressive Airway Management
Polyomavirus
- Non-enveloped
- Double-stranded DNA
- Circular
- BK Virus
- Kidney Damage
- JC Virus
- Progressive Multifocal Leukoencephalopathy (PML)
- HIV/AIDS
- Oligodendrocyte
- Demyelination of CNS
Charcot Marie Tooth Disease
- Hereditary Motor Sensory Neuropathy
- Autosomal Dominant
- PMP22 Duplication
- Schwann Cell Dysfunction
- Distal Muscle Weakness
- Foot Drop
- Calf Muscle Atrophy
- Scoliosis
- Hammertoes
- Pes Cavus
- Onion-skin Appearance on Nerve Biopsy
- Electrodiagnostic Studies
Internuclear Ophthalmoplegia
- Multiple Sclerosis
- Medial Longitudinal Fasciculus
- CN VI Nucleus
- CN III Nucleus