Explaining Chronic Neurological Conditions

Question 1

Rough structure for explanations

Answer 1

Brief history - symptoms, duration, impacts on ADLs
Understanding
Concerns
Explanation
-Normal functioning and disease
-Cause
-Problems
-Management
Summarise

Question 2

Multiple sclerosis

-explanation

Answer 2

Explanation
Normal functioning - imagine your nerves as wires, they’re covered in a plastic covering so any electrical signals travel efficiently from one point to another
MS - in MS, patches of the plastic covering of the wire gets destroyed by your immune system. As a result, the movement of electrical signals becomes less efficient, resulting in the symptoms you have been experiencing.

Cause - we don’t know why the immune system acts like this but we believe it’s due to a mixture of environmental and genetic factors

Problems

• As MS can affect any part of your spinal cord and brain, flare ups can present differently every time
• However you will be supported by a team that specialises in MS

Management
-The most common pattern of MS is relapsing remitting, there will be periods of time where you will have symptoms which will remit
-Treatment is focused around symptom management
For example
-Fatigue - sleep hygiene, regular exercise
-Muscle spasms, stiffness, pain - physio, gabapentin
-Burning pain - amitriptyline
-Mood - CBT, SSRIs
If the symptoms are particularly severe => CS

We can’t cure MS but we can support you with a medication that reduces the frequency and severity of your flares

Question 3

Dementias, Parkinsons

-explanation

Answer 3

Explanation
Normal - Our brain cells pass on electrical messages between each other, which helps us to think and carry out our daily tasks
AD - in Alzheimers, there is an abnornmal accumulation of proteins in and around the brain cells. This affects the transfer of messages between brain cells which results in the symptoms that you have been experiencing

Cause - we don’t know what triggers AD but we do know that some things can increase your likelihood of developing AD such as increased age, FHx, heart disease

Presentation
-memory loss, difficulties with thinking, problem solving

Management

• focuses on reduces the impacts of the symptoms and helps you to live well with AD
• group activities which aim to improve and maintain cognitive and social functioning in everyday life
• medication (donepezil, rivastigmine)

Things to think about

• as AD is a progressive condition, we may need to think about your future health needs
• there may be point where you are not able to communicate your wishes in relation to your healthcare and finances
• I understand that this can be difficult to think about but by planning ahead and discussing your wishes while you are able to with those closest to you and with the healthcare team supporting you, you can maintain control over your future care.

I appreciate that I have given you a lot of information so just to summarise the key points

• AD is a condition that affects our brain cells ability to pass on information, which can disrupt our short term memory and ability to carry out everyday tasks.
• our management focuses on slowing the progression and maintaining cognitive and social functioning in everyday life
• due to the progressive nature of the condition, it may be a good idea to think about your wishes in relation to future healthcare and your finances and plan ahead, should you not be able to make your wishes known

What I can do is pass you some leaflets highlighting what we’ve discussed today and some more information on advance care planning and what you may want to consider.
If you have any further questions, please don’t hesitate to get in contact with your GP, 111, the NHS website