MS and Neuroimmunology Neurology Highlights

Comprehensive vocabulary flashcards covering multiple sclerosis epidemiology, pathophysiology, diagnostic criteria, MRI findings, and pharmacological management based on the lecture notes.

Periventricular white matter lesions

MS lesions that follow a specific pattern in the distribution of the venules.

Benign MS

The classification for a patient with relapsing remitting MS with no disease activity for two years, occurring in $15\%$ of cases.

EDSS 6

The Expanded Disability Status Scale score for an MS patient capable of walking with a cane for $100\,meters$.

Optic Neuritis (MS-related)

Characterized clinically by unilateral pain with eye movement and a prolonged P100 on visual evoked latency.

Disease Progression Indicator

Clinical or imaging evidence of MS advancement, specifically marked by cerebral atrophy.

MS Genetic Risk (1st Degree Relatives)

The percentage of risk for a baby or dizygotic twin of an MS patient to develop the disease, estimated at $2-4\%$.

MS Genetic Risk (Monozygotic Twins)

The risk percentage for a monozygotic twin to develop MS if the other twin has it, estimated at $30-40\%$.

Black Holes

T1 hypo-intensities on an MRI that represent edema or permanent tissue destruction in MS.

Natalizumab (Tysapri)

A DMT that requires JC virus antibody screening due to the risk of Progressive Multifocal Leukoencephalopathy (PML).

Teriflunomide

An MS medication that inhibits pyrimidine synthesis and is known to cause paresthesia as a side effect.

Dalfampridine

A medication used to improve gait in MS patients, which is contraindicated in those with a history of seizures.

Ocrelizumab

A disease-modifying therapy (DMT) for MS that functions through a CD20 mechanism of action.

Alemtuzumab

A DMT targeting CD52 that can result in side effects such as hyperthyroidism and low platelet counts ($30\times 10^9/L$).

Fingolimod

A sphingosine-1-phosphate (S1P) receptor modulator that can cause a rebound effect of MS activity if stopped.

Aquaporin-4 (AQP4) antibodies

The most useful diagnostic marker for confirming a diagnosis of Neuromyelitis Optica (NMO).

Susac Syndrome

A clinical triad consisting of hearing loss, impaired vision, and "snowball" lesions in the corpus callosum on MRI T2/FLAIR.

ADEM (Acute Disseminated Encephalomyelitis)

A typically monophasic demyelinating condition common in children that can present with confusion or coma and bilateral white matter changes.

Schilder Disease

A rare MS variant seen mostly in children, characterized by bilateral symmetrical demyelination and cortical blindness.

Uhthoff Phenomenon

The temporary worsening of MS symptoms caused by the activation of unmyelinated axons, often due to heat.

Fatigue Treatment in MS

Managed by exercise as the mainstay, or medically with Amantadine $100\,mg$ BID or Modafinil.

MS Tonic Spasms

Brief, intensely painful cramps precipitated by movement or touch, effectively treated with Carbamazepine.

LETM (Longitudinally Extensive Transverse Myelitis)

A spinal cord lesion extending over $3$ or more segments, which is a cardinal feature suggestive of NMO.

CIS (Clinically Isolated Syndrome)

A single clinical episode suggestive of MS that does not yet meet the full criteria for dissemination in time.

RIS (Radiologically Isolated Syndrome)

Incidental MRI findings suggestive of MS in a patient who has no clinical history of neurological complaints.

Red Flags in MS Diagnosis

Clinical features that suggest a diagnosis other than MS, including bilateral INO, extensive TM, and enhancing lesions lasting more than $3\,months$.