PATHOSCHEMA® Immersive Experience (PIE) | Multiple Sclerosis ⛶ Expand Experience Soma Myelin Sheath Lipid insulator speeding conduction Node of Ranvier Na+ influx / K+ efflux regenerates signal 1. Immune Breach 2. Demyelination 3. Sclerosis Compromised Blood-Brain Barrier (Endothelium) CD4+ T-Cell B-Cell (Plasma) Macrophage Activity K+ Leakage (Signal Short-Circuit) Astrogliosis (Sclerotic Plaque) Wallerian Degeneration Irreversible Axonal Transection Cognitive Fatigue Optic Neuritis Intention Tremor / Ataxia Lhermitte's Sign Neurogenic Bladder Motor Spasticity 1. Bloods (Exclude) 2. Visual Evoked Potentials 3. MRI Brain & Spine 4. Lumbar Puncture Rule out Systemic Mimics B12, Folate, ANA, Syphilis, HIV Delayed P100 Latency Dissemination in Space (DIS) Dawson's Fingers SERUM CSF Unmatched Oligoclonal Bands (IgG) I. Acute Relapse II. Natalizumab III. Ocrelizumab IV. Symptomatic Systemic Circulation CNS Compartment Inflammatory Cell Apoptosis High-Dose IV Methylprednisolone VCAM-1 Adhesion Molecule Natalizumab (VLA-4 Integrin Blockade) B-Cell (CD20+) Ocrelizumab (CD20 Depletion) Detrusor Overactivity Anticholinergics (e.g. Oxybutynin) Motor Spasticity GABA Agonists (e.g. Baclofen) Clinical Evidence Mastery Question 1 of 10 Score: 0 Loading... 1. Physiology 2. Pathophysiology 3. Symptoms 4. Investigations 5. Management 6. Mastery
