LEC 5: Multiple Sclerosis (MS) Flashcards
What is multiple sclerosis (MS)?
Chronic, progressive, degenerative, autoimmune disorder of the central nervous system. Body starts to attack itself, the myelin.
- Brain and spinal cord
- There is no cure for MS
Where is the highest rates of MS in the world?
Canada has one of the highest rates of MS in the world
- 100,000 Canadians currently
When are people usually diagnosed?
Most people are diagnosed between the age of 15 to 40 years old
What are the non-modifiable risk factors associated with MS?
- Gender: Affects women more then men (3:1)
- Race: Caucasians of northern European descent
- Family history: Small increased risk (3% increased risk)
- Environment: Cool climate, little sunshine
- Diet: Low in vitamin D levels
What are the three factors that play into MS (etiology and pathophysiology)?
- Immune system
- Genetics
- Environment
- Exposure triggers an abnormal immune response
*Don’t know what causes MS
CNS, MS, and the Role of the Immune System
a. Normally, we have nerve cells consisting of a nerve fiber, in the fiber there is myeline which helps transfer signals to the body
b. With MS, the body starts to attack itself, the body sees the myelin as a foreign invader
c. T-Lymphocytes determine that there is something foreign in the CNS system.
d. The T-lymphocytes migrate to the CNS and start to attack the myelin and stimulate other cells that help protect the body. Will eventually damage the nerve fiber and cause scar tissue to myelin
- Once the nerve fiber is damaged it cannot be repaired.
- The symptoms of MS will depend where the damage is happening in the CNS
e. Once the myelin is damaged the nerve impulses start to slow and if the nerve fiber is damaged then the nerve impulses cannot continue within the CNS part
- The immune system does not attack the brain and spinal cord all at once. It targets specific areas and is unpredictable. Will happen at different areas of the body at different times
When can myelin repair itself?
Can be regenerated if oligodendrocytes are intact, they make to myelin. But if the oligodendrocytes become damaged they cannot regenerate the myelin
What are the four types of MS?
- Relapsing remitting
- Primary progressive
- Secondary progressive
- Progressive relapsing
Relapsing Remitting
- Remission: Recovery nearly complete
- Relapsing: Flare up of the disease, when the symptoms re-occur
*Flare up are more common at the beginning of the diagnosis then towards the end
Primary Progressive
- Slow accumulation of disability
- Without defined relapses
- No distinct flare up or relapsing remitting
Secondary Progressive
- Follows relapsing remitting
- Distinct relapses and remissions less apparent
- Increasing levels of disability
Progressive Relapsing
- Symptoms steadily worsen
- Faster then the primary progressive
What do the medications for MS do?
Medications suppress the immune system therefore they are immunocompromised
What are the clinical manifestations (signs and symptoms) of MS?
- Signs and symptoms vary depending on the specific areas of the CNS affected
- Symptoms may be vary vague at first; hard to pinpoint because it attacks the body in different areas
- Fatigue (#1 symptom)
- Weakness
- Depression
- Shaking and loss of coodination
- Memory changes
- Numbness and tingling
- Pain
- Bladder and bowel dysfunction
- Visual loss
- Double vision
- Sexual dysfunction
- Unsteadiness and dizziness
What is the best way to diagnose MS?
MRIs are the best way to diagnose MS
What are the systemic effects of MS?
MS effects every body system
- Respiratory system
- Urinary system
- Gastrointestinal system
- Musculoskeletal system
- Neurological system
- Sensory system
- Reproductive system
MS Effects on the Respiratory System
- Diminished cough reflex
Potential Complication
- Respiratory infections
MS Effects on the Urinary System
- Hesitancy
- Frequency
- Retention
- Reflex bladder emptying
Potential Complication
- Recurring UTIs
- Incontinence
