Multiple sclerosis

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Multiple sclerosis, abbreviated MS, is a chronic inflammatory condition of the central nervous system.

General

  • A bread 'n butter disease of neurology in Canada.

Clinical:

  • CSF: oligoclonal bands of immunoglobulin.[1]

Classification of MS lesions:

  • Early active.
  • Inactive.
  • Early remyelinating.
  • Late remyelinating.

Radiologic/Gross

Features:[2]

  • White matter lesions.
    • Cerebrum (classically): periventricular distribution.
    • Optic nerves (optic neuritis) - classic presentation.

Microscopic

Features:[3]

  • Perivascular inflammation.
    • Esp. lymphocytes.
  • Demyelination.
    • Subcortical myelinated fibers are often spared.

Chronic lesions - specific features:[4]

  1. Macrophages.
  2. Astrocyte enlargement.

DDx:

Images

www:

IHC

  • HAM-56 - macrophages.
  • CD8 - lymphocytes.

See also

References

  1. Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1311. ISBN 978-1416031215.
  2. URL: http://library.med.utah.edu/kw/ms/path.html. Accessed on: 12 July 2010.
  3. URL: http://library.med.utah.edu/kw/ms/path.html. Accessed on: 12 July 2010.
  4. Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 425 Q43. ISBN 978-1416025887.