Summary: Lecture 2 Neuropsychological Problems In Ms And Epilepsy
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1 Lecture 2 Neuropsychological problems in MS and Epilepsy
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What are risk factors for MS?
- Genetic factors: higher risk in persons with a first degree relative
- Low vitamin D
- Epstein-Bar Virus
- Smoking, 1,5 times higher risk
- More common in women than in man -
What are the main symptoms of MS?
- Dysphagia: difficulty swallowing
- Dysarthria: speech
- Cognitive problems both in early and late stages
- Visual symptoms are common in the beginning of MS
- Musculoskeletal problems: weakness, spasms, ataxia
- Sensation: pain, hypoesthesias, paraesthesias
- Bowel problems: incontinence, diarrhea or constipation
- Urinary problems: incontinence, frequency or retention -
Diagnostic criteria of MS (McDonald 2017)
Dissemination in space:asymptomatic lesions typical ofMS present in 2 or more sites within thecentral nervous system.Dissemination in time: requires that 2attacks separated by more than 30 days haveoccurred in different parts of theCNS . -
How is MS diagnosed?
- Neurological exam: anamnesis, tests of cranial nerves, sensation, reflexes, coordination, walking and balance.
- MRI
- Blood tests
- Spinal tap
- Evoked potential tests -
What are common neuropsychological problems in MS?
- Major depression
- Bipolar affective disorder
- Eurphoria
- Psychosis
- Personality change -
Brief batteries for MS
Brief Repeatable Neuropsychological Battery (BRNB)
Brief International Cognitive Assessment for MS (BICAMS) -
Intermediate length batteries for MS
Minimal Assessment of Cognitive Function in MS (MACFIMS) -
How can cognitive problems in MS be treated?
- Disease modifying therapies: weak positive effects on cognition
- Acetylcholinesterase inhibitors
- Behavioral interventions: limited data available -
What are the characteristics of focal seizures without loss of consciousness?
- May alter emotions
- Change the way things look, smell, feel, taste or sound
- Involuntary jerking of a body part
- Sensory symptoms, e.g. Tingling, dizziness, flashing lights -
What are the characteristics of focal seizures with impaired awareness?
- Change of/loss of consciousness or awareness
- Stare into space and not responding normally to the environment
- Perform repetitive movements
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