[MND] Multiple Sclerosis

Question 1

Multiple Sclerosis is an

Answer 1

autoimmune disease resulting in demyelination of central nervous system (CNS) neurons (their axons) resulting in delays or blocks in neural transmissions

Question 2

Primary progressive MS can be described

Answer 2

Progressive and cumulative neurological deficit and disability

Question 3

Benign MS can be described as

Answer 3

One or two relapses and remissions resulting in full recovery and no disability

Question 4

Secondary Progressive can be described as

Answer 4

Recurrent relapses and remissions developing into progressive deterioration. Disability increases.

Question 5

Relapsing-Remitting MS can be described as

Answer 5

Recurrent relapses and remission resulting in complete or partial recovery

Question 6

Epidemiology: MS

Answer 6

• 1 case per 1000 in NZ
• Onset commonly occurs between the ages of 20 and 40 years
• Affects women 3 times more frequently than men

Question 7

Talk about the distribution of plaques in MS

Answer 7

Pathological examination of the brain and spinal cord reveals characteristic plaques of MS which are predominantly in the white matter
The lesions are random throughout the cerebral hemispheres, the brain stem, the cerebellum and the spinal cord

Question 8

Talk about remyelination in MS

Answer 8

A repair process which can occur following an acute inflammatory demyelinating episode / early stages of MS but appears thinner than the original myelin. It may allow functional recovery but oligodendrocytes are unable to rebuild it completely

Question 9

Repeated attacks can cause a build up of

Answer 9

scar-like plaque around the damaged axons which blocks nerve conduction permanently

Question 10

MS is characterised by a loss of oligodendrocytes which

Answer 10

gives off a number of processes which ensheath surrounding axons (insulation), enveloping the axon producing/resulting in a myelin segment

Question 11

Lesions located in the brain stem can affect speech resulting in

Answer 11

Dysarthria (articulating speech)

Question 12

Affects on the musculoskeletal system include

Answer 12

weakness, spasms, ataxia

Question 13

The are the two most common symptoms of MS?

Answer 13

• Presentation of visual loss (usually unilateral)

- Neurological deficits (weakness, numbness, unsteadiness, slurred speech, nystagmus, intention tremor)

Question 14

Diagnosis?

Answer 14

Based on presenting signs and symptoms in combination with:

1) MRI
2) Lumbar Puncture (for cerebrospinal fluid)
3) Evoked Potentials (tests can include visual, brain stem, auditory, somatosensory evoked potentials)

Question 15

Maintaining and increasing range of motion, maintaing and encouraging weight-bearing and encouraging postural stability can be considered

Answer 15

Some primary aims of physiotherapy

Question 16

What is ‘Disease Steps’

Answer 16

An ordinal clinical rating scale developed to provide a straightforward assessment of functional disability in MS primarily based on ambulation. 0 (normal) to 6 (wheelchair)