406 E2: multiple sclerosis Flashcards
MS definition
chronic, inflammatory autoimmune disorder that targets both the white and gray matter of the spinal cord and involves the degeneration of CNS myeline or loss of myelin sheath w/ scarring
MS characteristics
-inflammation of the white matter of brain and spinal cord
-demyelination of the nerve fibers
-development of scar tissue (gliosis)
MS etiology
unknown but autoimmune so likely a genetic predisposition that was triggered
MS risk factors
age: 20-40
gender: women
location: moderately cool climate
race: caucasian
genetics: fam hx
possible risk factors for MS
smoking
vit D deficiency
obesity
infection (including epstein-barr)
MS pathogenesis
T lymphocytes migrate to the CNS and cross the blood brain barrier -> antigen antibody reaction in CNS initiates an inflammatory response -> axons are de myelinated & plaques / sclerosis forms -> axons are destroyed
axon is the nerve itself
loss of myelin…
disrupts nerve conduction & w/ subsequent death of neurons and brain atrophy
neurons in early disease
-nerve fiber not affected
-impulses still transmitted
-may notice weakness
neurons in a more progressed disease
-axons are destroyed
-impulses are totally blocked
-permanent loss of function
MS subtypes: benign
there is an exacerbation of symptoms but after the flare subsides, there is a return to baseline
they recover and there is no loss of function once they are back at baseline
MS subtypes: relapsing - remitting
most common form
long periods of remission w/ few exacerbations, the pt is stable between exacerbations and there is minimal disability or progression of the disease
won’t necessarily return to their baseline & may have some permanent deficits, will be weaker than baseline and each time there is a flare they do not recover all the way
MS subtypes: primary - progressive
a gradual progression of symptoms without periods of remission
MS subtypes: secondary - progressive
there is an initial relapsing or exacerbation followed by remission w/ some loss of function with each exacerbation but changes course and loses the periods of remission
MS subtypes: progressive - relapsing
there is a gradual progression of symptoms and also exacerbations and they have fewer remissions
what is the most common initial symptoms of MS
-paresthesia of the face, trunk or limbs d/t nerves no longer innervating the muscles
-loss of muscle function
-numbness
-tingling
-optic neuritis / unilateral vision loss
-impaired gait
-urinary incon
-seizures
symptoms to monitor w/ MS
-cognitive problems (cog fog)
-vision problems
-depression
-fatigue
-pain (acute, chronic, burning, stabbing)
-bowel/bladder
-weakness
-sexual issues
-muscle stiffness/spasm
-walking/balance
cog fog
difficulty thinking clearly and concentrating
not a memory thing
