123 - multiple sclerosis part 2

1. total volume of the T2 weighted signal abnormality shows significant correlation with clinical disability

2. MRSI can quatitate molecules like N acetyl aspartate which is marker for axonal integrity

3. mononuclear cell pleocytosis is seen in CSF

4. pleocytosis of greater than 75 suggested some other diagnosis rather than MS

5. increased level of intrathecally synthesized Ig G

6. protein concentration of greater than 100 mg/dl suggests some other diagnosis rather than MS

7. two or more oligoclonal bands are seen in CSF

8. patients with optic neuritis at onset have good prognosis

9. patients with sensory symptoms at onset have good prognosis

10. complete recovery from early attacks favour good prognosis

11. patients less than 40 years of age have good prognosis

12. women have good prognosis when compared to men

13. patients with RRMS course have good prognosis

14. patients with less than two relapses in the first year have good prognosis

15. progressive disease has good prognosis

16. presence of truncal ataxia has bad prognosis

17. if the symptoms begin from childhood then the patient has bad prognosis

18. presence of action tremor indicate bad prognosis

19. presence of pyramidal symptoms indicate bad prognosis

20. pregnant MS patients experience fewer attacks than expected ( especially third trimester )

21. more attacks experienced at 3 months post partum

22. when considered pregnancy as a whole ( 9 months pregnancy + 3 months postpartum ) the overall disease course is unaffected .

23. interferon beta 1 A , interferon beta 1 B, glatiramer acetate, mitoxantrone, natalizumab are the drugs used in the disease modifying therapies for relapsing forms of MS

24. separate attacks of acute optic neuritis and myelitis indicate NEUROMYELITIS OPTICA ( NMO ) rather than MS

25. brain stem, cerebellar and cognitive involvement indicate MS rather than NMO .

26. focal enhancing region of swelling and cavitation over 3 or more spinal cord segments in MRI favour a diagnosis of NMO rather than MS

27. association with systemic autoimmune disease like SLE favours NMO rather than MS

28. if the brain MRI is normal it indicates a diagnosis of NMO rather than MS

29. fulminant demyelinating acute MS without remissions leading to death within 1 to 2 years is called as MARBURG’S VARIANT .

30. presence of widely scattered small foci of perivenular inflammation and demyelination is characteristic of Acute Disseminated EncephaloMyelitis (ADEM )

31. ADEM follows smallpox and rabies vaccine

32. introduction of live measles vaccine has dramatically reduced the incidence of ADEM and now ADEM is mostly associated with chicken pox rather than measles infection .

33. meningismus, drowsiness, coma or seizures indicate ADEM rather than MS

34. bilateral optic nerve involvement is characteristic of ADEM

35. treatment of steroids, plasma exchange and IV Ig .

36. treatment for multiple sclerosis is Interferon BETA .