Multiple_Sclerosis

Multiple_Sclerosis - MultipleSclerosis AliAlrefai,MD Dec...

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Dec 24, 2011 Multiple Sclerosis Ali Alrefai, MD
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Dec 24, 2011 Demyelinating Conditions Multiple Sclerosis  Progressive Multifocal Leukoencephalopathy Acute Disseminated  Encephalomyelopathy (ADEM)  Post infectious, post-vaccinial leukoencephalitis Infection induced demyelination  Demyelination of autoimmune disease eg “lupoid sclerosis”,  Hashimoto’s related demyelination Dysmyelinating Conditions  Transverse Myelitis  Tropical Spastic Paraparesis  Progressive mulitfocal leukoencephalopathy  SSPE
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Dec 24, 2011 ADEM Problem diagnosis is it MS or ADEM?? ADEM  fulminent single attack Post viral or post vaccination esp  Rabies Can be acute hemorrhagic leukoencphalitis  May require aggressive therapy e.g. iv Cyclophosphamide  or plasmapheresis
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Dec 24, 2011 Tropical Spastic Paraparesis Now Ass’d with HTLVI  i.v. drug use, positive sexual partner, breast milk, blood  transfusion  No known established treatment  Trials with Steroids Interferon Beta 1a
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Dec 24, 2011 MS A disease leading to the destruction of Central  Nervous system Myelin. Characterized by relapses  and remissions in 85% of cases at presentation destruction of myelin by the immune system
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Dec 24, 2011 Epidemiology 3.2/10 5 /year 400,000 people in the United States 2/3 women  Young adults between the ages of 20 and 40 Geographical variation
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Dec 24, 2011 What Causes MS?? We don’t know  Best Theory:  MS is a chronic infection  The Immune system plays a role Inherited  characteristics of their immune system e.g.  HLA types  (DR2, A3, B7, DQW1, bl, al 30% monozygotic twins 5% dizygotic twins First-degree relative: x10-20
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Dec 24, 2011 Pathology Plaques: Areas of demyelination Deep white matter Near ventricles, corpus callosum, optic nerve May occur in spinal cord, gray matter, and brain stem 
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Multiple_Sclerosis - MultipleSclerosis AliAlrefai,MD Dec...

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