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