Types of Ms
Relapsing-Remitting (cycling)
Primary progressive
Secondary progressive
Progressive relapsing
Types of relapsing remitting MS
Benign
Clinically isolated
Relapsing remitting MS
Unpredictable but defined episodes
Recovery between attacks complete or nearly complete.
85% have RRMD at time of Dx
Benign MS
Subtype of RRMD
Remission stage is almost always complete; little progression of symptoms.
Usually affects sight and/or touch
Clinically isolated MS
Subtype of RRMS
“Probable Ms”
Single episode of symptoms.
MRI or evoked potentials may find evidence of another subclinical attack
Primary progressive MS
Slow accumulation of disability, without remission.
May plateau, but never improves.
10%
Only form to affect men and women equally.
Dx after 40.
Secondary progressive MS
Distinct remission/relapse pattern which, over time, diminish as disease becomes steadily progressive.
50% with RRMS develop SPMS within 10 years of Dx.
Progressive relapsing MS
Rarest and worst.
5%.
Steady decline from onset, with periods of increased severity of symptoms.
MS lesions found
White matter, often brainstem, cerebellum, SC
Can also affect CN, especially Optic (II) and Trigeminal (V).
Tic Doloureoux
Lesion of Trigeminal nerve (V)
Symptoms of MS
Intention tremors Circumducted gait Spacticity Weakness Impaired proprioception Paresthesia
MS
Demyelination and fibrosis (sclerotic plaques) of nerve
Slow or blocked transmissions
Average AOO: 20-40
Genetic. Immunological. Environmental. Viral.