Physiology & Biochemistry · patient case question
Multiple sclerosis, a demyelinating disorder of oligodendrocytes, is best classified as:
Patient case: Syndromes recognised at the chair
demo: Paediatric and young adult clinic
chief: Several patients whose facial and dental features point to a recognisable syndrome.
history: One child has bilateral painless expansion of the mandibular angles with an upward gaze, and a father with the same childhood history. Another has downslanting palpebral fissures, malar hypoplasia and malformed external ears. A third has notched, screwdriver-shaped permanent incisors and multicusped first molars. A fourth has a smooth philtrum, a thin upper lip and short palpebral fissures.
meds: None.
findings: Not applicable.
Show answer and explanation
Correct answer: C. An autoimmune condition
- A. MS is not present at birth and does not arise from a developmental error. It typically appears between 20 and 40 years.
- B. A reactive process follows a defined local stimulus and resolves when that stimulus is removed, which does not describe MS.
- C. Correct. Multiple sclerosis is an autoimmune demyelinating disease in which T cells attack oligodendrocytes and the central nervous system myelin they produce. Relevant to dentistry, it can present with trigeminal neuralgia, particularly bilaterally or in a young patient, and facial weakness, sensory disturbance and dysphagia may follow.
- D. There is no neoplastic proliferation; the pathology is inflammatory demyelination with plaque formation.
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