Discription of disease and comparision values and findings

1. Misbah Azher
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2.  MRI Scan – MS
 LP (Spinal Tap) in MS and GBS
 NCV in GBS

3.  It is an inflammatory and demyelinating disease in which the fatty myelin sheaths
around the axons of the brain and spinal cord are damaged, presenting as a broad
spectrum of signs and symptoms,

4.  MS is confined to the CNS, causing demyelination of ascending and descending
tracts.
 The inflammation and demyelination with loss of myelin sheath results in breakdown
of the insulation around the axons and the velocity of AP is reduced and ultimately
becomes blocked.
 RISK FACTORS
-Most cases occur between the age of 20 and 40 years.
-Females are affected more than males
-May interplay between a viral infection, host immune response.

7.  MS is a clinical diagnosis. It is diagnosed by neurological examination and brain MRI
scans.
 Family history and lumber puncture are also used for diagnosis.

8.  MRI of the brain is the most accurate test to diagnose MS, reaching a sensitivity of 85
to 95% in symptomatic persons.
 MRI findings May show many plaques. MRI reveals multiple lesions with high T2
signal intensity and one large white matter lesion. These demyelinating lesions may
sometimes mimic brain tumors because of the associated edema and inflammation.
 Enhancement of lesions with gadolinuim indicates active MS lesions that may
enhance for up to 2 to 6 weeks after an exacerbation.

9.  Comparision of normal brain tissue with MULTIPLE
SCELORSIS

10.  Mult

11. T1 T2 FLAIR

12.  Dawsons Fingers MS plaques extending up through corpus
callosum.

15.  Optic neuritis(ON) is a common and typical manifestation.
 The optic nerve is acutely inflamed in all instances of optic neuritis, so that pain in the orbit
on eye movement is a common symptom.

17. If MS is present, ,An elevated IgG index is found in 70
to 90% of patients with MS. can be seen in spinal
fluid which is an additional confirmatory test.
 During the acute phase of GBS, characteristic
findings on CSF analysis include albuminocytologic
dissociation, which is an elevation in CSF protein
(>0.55 g/L) without an elevation in white blood cells.
The increase in CSF protein is thought to reflect the
widespread inflammation of the nerve roots.Seen
after 48 hrs of symptoms onset.

18.  Nerve conduction velocity (NCV)—This test is performed with EMG, and together,
they are often referred to as EMG/NCV studies. NCV records the speed at which
signals travel along the nerves. Motor NCVs are greatly reduced, and sensory nerve
conduction time is often slow. Slowed nerve conduction velocities, absent F waves,
and prolonged or absent H-reflexes are all findings that support demyelination
 Electromyogram (EMG)—This is an effective diagnostic tool because it records
muscle activity and can show the loss of individual nerve impulses due to the
disease's characteristic slowing of nerve responses.