Multiple Sclerosis Features and Mechanisms
- Twice as often 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
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
Lambert-Eaton Syndrome
- Autoantibody to the Presynaptic Calcium Channel on Motor Neurons
- Inhibits Acetylcholine (ACh) Release at Neuromuscular Junction
- Paraneoplastic Syndrome
- Small Cell Lung Cancer
- Proximal Muscle Weakness
- Improves with Muscle Use
- Autonomic Symptoms
- Extraocular Muscle Sparing
Autonomic Dysreflexia
- Injury Above T6
- Paroxysmal Hypertension
- Bradycardia
- Diaphoresis
- Flushing Above Lesion
- Piloerection
- Nasal Congestion
- Headache
- Elevate Head of Bed
- Remove Noxious Stimuli