multiple scelerosis
TRANSCRIPT
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Multiple Sclerosis
Dr Bhupendra ShahAssistant ProfessorB.P. koirala Institute of Health Sciences
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Beautiful movie………..
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MULTIPLE SCLEROSIS
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WHERE IS MULTIPLE SCLEROSIS?
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PATHOPHYSIOLOGY OF MULTIPLE SCLEROSIS
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Clinical features:
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Few interesting symptoms…
• Uhthoff’s phenomenon
• Lhermitte’s symptoms
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VARIANTS OF MULTIPLE SCELEROSIS
PROGRESSIVE RELAPSING
SECONDARY PROGRESSIVE
PRIMARY PROGRSSIVE
RELAPSING AND REMMITING
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INVESTIGATION
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PLAQUE
MRI in Multiple Sclerosis
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CSF IN MULTIPLE SCELOROSIS
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MC DONALD CRITERIA FOR MULTIPLE SCLEROSIS
ATTACK CLINICAL LESION
REQUIREMENT
2 2 None
2 1 Dissemination is space by MRI(in different areas)
1 2 Dissemination in time by MRI(different lesion new and old)
1 1 Dissemination in space and time
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TREAMENT
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• Acute exacerbation usually in relapsing and remmiting variants
• Shorter course
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Symptomatic managmentPROBLEM DRUGS
Spasticity Physiotherapy, muscle relaxant
Ataxia Isoniazide, clonazepam
Dystheisia Carbamazepine, amitriptyline
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TAKE HOME MESSAGE
• inflammatory disease of white matter of CNS .
• Shows relapsing and remmiting pattern
• MRI is choice of investigation
• Immunomodulator is a drug of choice .