Read the summary and the most important questions on Lecture 2 Neuropsychological problems in MS and Epilepsy

• 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 of MS present in 2 or more sites within the central nervous system.
  Dissemination in time: requires that 2 attacks separated by more than 30 days have occurred in different parts of the CNS.

• 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