8 multiple sclerosis

Question 1

Multiple Sclerosis (MS)

Answer 1

a progressive demyelinating disease
that effects the myelin sheath of neurons in
the CNS
 Onset usually occurs between ages 20-40, and
affects twice as many women as men

Question 2

Multiple Sclerosis (MS) pathophysiology

Answer 2

Exact cause of MS is unknown
 MS affects the white mater of the brain and
spinal cord by causing scattered demyelinated
lesions
 Damaged sheath impairs normal nerve
conduction

Question 3

plaques

Answer 3

Myelin sheath becomes inflamed and the
membrane layers break down into smaller
components known

Question 4

Clinical Manifestations Multiple Sclerosis (MS)

Relapsing – remitting

Answer 4

may be unpredictable and difficult for the patient to
describe and the course of the disease varies form person to person
 Frequently, the disease is relapsing and remitting, has exacerbations and recurrences of symptoms including fatigue, weakness, numbness, difficulty in coordination, loss of balance, pain and visual disturbances

Question 5

Four clinical patterns Multiple Sclerosis (MS)

Answer 5

 Relapsing – remitting
 Secondary progressive
 Primary progressive
 Progressive relapsing

Question 6

Clinical manifestations multiple sclerosis

Answer 6

 Dysarthria
 Dysphagia
 Weakness or tingling sensations of one or more
extremities
 Vision loss
 Incoordination
 Bowel and bladder dysfunction

Question 7

diagnostic test Multiple sclerosis

Answer 7

 EEG shows abnormalities in 30% of patients
 CSF analysis reveals elevated immunoglobulin G levels
 CT scan may disclose lesions in the brain’s white
matter
 MRI most sensitive method for detecting lesions and
progression of the disease

Question 8

Treatment multiple sclerosis

Answer 8

 Aim: shorten exacerbations and relieve neurologic
deficits
 Steroids: prednisone, dexamethasone
 Interferon beta-1a or interferon beta -1b
 Antidepressants: chlordiazepoxide
 Baclofen

Question 9

 During acute exacerbations: multiple sclerosis

supportive measures

Answer 9

 Bed rest
 Massage
 Prevention of fatigue
 Prevention of pressure ulceration
 Bowel and bladder training
 Antibiotics for bladder infections
 Physiotherapy
 Counselling

Question 10

Multiple Sclerosis Society of NSW

Answer 10

 Information
 Professional assessment and treatment
 Counselling
 Support groups
 Advice and support on recreational and leisure activities
 Respite care
 Nursing Home Support Program
 Education for community and health professionals

Question 11

Myasthenia Gravis

Answer 11

 Autoimmune disorder affecting the nueromuscular
junction
 Antibodies directed at acetylcholine at the
nueromuscular junction impair transmission of
impulses

Question 12

 Manifestations Myasthenia gravis,

Answer 12

a motor disorder
 Initially symptoms involve ocular muscles; diplopia and
ptosis
 Weakness of facial muscles, swallowing and voice
impairment (dysphonia), generalised weakness

Question 13

Medical Treatment Myasthenia Gravis

Answer 13

 Pharmacological therapy
 Cholinesterase inhibitor: pyrostigmine bromide
(Mestinon)
 Immuno-modulating therapy: azathioprine (Imuran)
 Plasmapheresis
 Thymectomy

Question 14

Myasthenia Gravis suportive measures

Answer 14

 Adjust eating routine.
 Use safety precautions at home
 Use electric appliances and power tools.
 Wear an eye patch
 Plan ADL’s to conserve energy
 Counselling