GF6: Neuro Multiple Sclerosis Flashcards
What is Multiple Sclerosis (MS)?
- an autoimmune disease that causes progressive demyelation of neurons
- Loss of myelin affects motor, sensory and autonomic fibers
- Can cause muscle spasms and stiffness
What are the dx tests for MS?
- MRI: will show plaque on brain and spinal cord
- EMG (Electromyography) to evaluate muscle electrical activity
- Lumbar puncture: will show high levels of antibodies
What are the results of the dx tests that will confirm dx of MS?
Sclerotic brain plaques in white matter
Elevated gamma globulin in CSF
What are the s/s of MS?
- Muscle spasticity
- Ataxia
- Urinary retention
- Hyperreflexia of extremeties
- Decreased concentration
- Fatigue
- Double vision, blurry or darka
What are the 4 “S’s” to avoid triggering MS flare ups?
- Stress (exercise, surgery, injury)
- Sickness (or sepsis)
- Smoking
- Sun (extreme heat)
What are some ways to promote independence for an MS pt?
- Teach self care ADLS, but don’t do for them
- Gait training if walking is affected
- Teach 1st
- Then offer cane, walker, wheel chair. In that order
What is the goal of pharmacological tx for MS?
Lengthen remission and shorten exacerbation
What is the pharmacological tx for MS?
- IVIG: body attacks IVIG instead
- Interferon: interferes with body attacking itself
- Steroids: to decrease swelling
- Muscle relaxants (baclofen): for muscle spasms
- Cyclosporine: immunosuppressant (most important)
What is the teaching for cyclosporine?
Report any signs of infection and bleeding
NOT for pregnant clients
True or False
PTs w/ MS should be bathed in hot water
False, It can cause a flare up
Where should a client rest to avoid fatigue w/ MS?
Rest in an airconditioned room
What are the clinical manifestations that indicate MS?
Charcot’s triad
Lhermitte’s sign
What is Charcot’s triad?
- Nystagmus
- Involuntary rhythmic side-to-side, up and down or circular motion of the eyes
- Intention tremor
- Involuntary, rhythmic muscle contractions (oscillations) that occur during a purposeful, voluntary movement.
- Dysarthria
- occurs when the muscles you use for speech are weak or you have difficulty controlling them
What is Lhermitte’s sign?
Electric shock like sensation radiating down spine into extremities when neck is flexed
What results from a spinal tap indicate MS?
- Increased protein, T-cells and IgG
- Presence of oligoclonal bands
- 95% of MS pts have abnormal IgG antibody
A pt has a PET scan. What glucose information is indicative of MS?
Decreased glucose uptake
True or False
MS is more common in females and is genetic.
True
How does MS affect hearing?
Tinnitus and decreased hearing
What are the cognitive manifestations of MS?
- Short term memory
- Short attention span
- Difficulty w/ info processing and planning
- Altered visual perception
- Word finding
How does MS affect the GI system?
MS onset is generally in what age range?
20-40 yrs
True or False
MS weakness of limbs, trunk and head can progress to paralysis
True
How does the relapsing – remitting cycle progress?
Severity of symptoms gradually advances after every exacerbation (like set of stairs)
How does secondary progressive MS advance?
A few relapse -remitting cycles will be followed by a steady ramp up of severity in symptoms
