Multiple Sclerosis

Multiple Sclerosis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Pathophysiology: Recurrent episodes of CNS demyelination:
    • Signs and symptoms depend on location of lesions and timing of demyelination
  • Multiple sclerosis (MS) occurs in distinct patterns:
    • Relapsing recurring MS: 2 or more episodes lasting ≥24 hr separated by ≥1 mo
    • Primary progressive MS: Slow or stepwise progression over at least 6 mo
    • Secondary progressive MS: Initial exacerbations and remissions followed by slow progression over at least 6 mo
    • Stable MS: No progression (without treatment) over at least 18 mo

Etiology

  • MS is a chronic demyelinating disease of CNS:
    • Etiology is not well understood
  • Presumed to be T cell–mediated autoimmune disease
  • There is evidence for a viral trigger
  • Plaques in white matter:
    • Characterized by infiltrate of T cells and macrophages
  • Persons of northern European origin most often affected (in US)
  • Increased prevalence is seen moving away from equator

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Citation

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TY - ELEC T1 - Multiple Sclerosis ID - 307560 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307560/all/Multiple_Sclerosis ER -