Astavalence

          
              Na⁺ channels cluster at nodes
              myelin raises resistance + lowers capacitance
              CNS oligodendrocyte
            
              blood–brain barrier
              T
              B
              Mφ

              inflammation strips myelin
              current leaks → slower signal → conduction block
            
              optic neuritis
              motor/spinal tract
              tremor / ataxia
              EDSS visual band: 2
            
              Story
              Exam
              MRI
              CSF
              Mimics
              MS?

                MRI: space + time
              
                CSF OCBs
              
                exclude mimics
                
                B12 / thyroid / infection
                AQP4 / MOG when atypical
                vascular / migraine patterns
              
              Relapse
              BBB
              B cells
              Lymph
              Pool
              Function
              acute inflammation
              immune trafficking
              future disease activity
              rehab + symptom control
              
              use the flashcard, then hide labels and explain the chain
              
              NICE NG220: UK diagnosis, relapse and symptom guidance
              NHS England: DMT treatment algorithm
              ABN: specialist DMT consensus guidance
              NCBI Bookshelf: myelin, nodes and MS pathology
            
        CellOligodendrocyte myelinates CNS axons.
InsulationHigh membrane resistance; low capacitance.
NodeNa⁺ channels regenerate the impulse.
ResultFast, reliable saltatory conduction.
EntryImmune cells cross a permissive BBB.
DamageMyelin breaks; membrane is exposed.
PhysicsCurrent leaks before the next node.
FailureLow reserve causes conduction block.
MapSymptoms follow lesion location.
VisionOptic conduction failure blurs colour and acuity.
MotorSpinal/corticospinal lesions affect gait.
SeverityEDSS band is a visual guide, not a score.
StartTypical story plus objective examination.
MRILesions show space and time pattern.
CSFOCBs support CNS inflammation.
SafetyExclude mimics before calling it MS.
RelapseSteroids act at acute inflammation.
DMTTarget future inflammatory activity.
SymptomsSpasticity, fatigue and bladder need active care.
DecisionNICE/NHS algorithm + specialist MDT.
TestExplain the mechanism without labels.
EvidenceOpen the links before using clinically.