MS

Question 1

What is MS?

Answer 1

an autoimmune disorder with inflammation, demyelination, and gliosis

Question 2

Where does MS occur?

Answer 2

in the brain and spinal cord! CNS issue

Question 3

What does demyelination do?

Answer 3

compromises nerve function and slows conduction velocity

Question 4

What is the major cause of disability in the young MS pt?

Answer 4

relapse or progressive disorder of the CNS white matter

Question 5

What part of the CNS is being damaged specifically?

Answer 5

Myelin
Oligodendrocytes
axons

Question 6

What demographic is most affected?

Answer 6

white further away from the equator

Question 7

MS risk factors?

Answer 7

family hx

Question 8

What may trigger MS?

Answer 8

genetic

exposed to virus (E-B, Measles, Mumps, herpes-6)

Question 9

How is this first triggered? *autoimmune wise?

Answer 9

immune response triggers immune cells that cross the BBB, and it response in the CNS, causing remyelination of the oligodendrocytes, then lesions throughout the CNS progress

Question 10

early stages what type of neural matters are affected? later stages?

Answer 10

early: white matter
later: grey matter

Question 11

What is RRMS (relapsing-remitting)?

Answer 11

• discrete attacks of neuro deficits with full or partial recovery aka known as “silent attacks”
• recovery can take weeks to months
• no progression between relapses
• 85% of MS population

Question 12

What is SPMS (Secondary Progressive)?

Answer 12

• initially starts as RRMS
• but steady deline with or without accute attacks
• most RRMS progress to SPMS without meds
• may be due to axonal loss, not bc of new lesions

Question 13

What is PPMS (primary progressive)?

Answer 13

• progressive course and steady functional decline from the onset
• modest fluctuation in neuro disability with no attacks
• associated with later onset (40yo.)
• affects 10% of all MS population

Question 14

What is PRMS (Progressive-Relapsing)?

Answer 14

• steady decline with acute attacks since onset
• continuous progression inbtwn attacks
• affects 5% of MS pts.

Question 15

What are Exacerbations (Relapses)?

Answer 15

-new & recurrent S&S that last >24 hr

Question 16

What are exacerbating factors?

Answer 16

infections
major organ disease (ie hepatitis, asthma)
stress

Question 17

What are Pseudoexacerbations?

Answer 17

<24 hr

Question 18

What is Uthoff syndrome? and what is S&S?

Answer 18

anything that increases body temp

flex neck forward and feel electricity in body

Question 19

What is affected if you see Nystagmus?

Answer 19

Cerebellum

Question 20

MS experience tingling and burning sensation, what is that called?

Answer 20

paresthesia

dysesthesia

Question 21

Lhermitte’s sign?

Answer 21

phenomenon of feeling electricity through the body

Question 22

In MS if CN is damaged how is their vision affected?

Answer 22

diplopia

Question 23

UMN signs due to corticospinal damage results in what?

Answer 23

paresis
spasticity
increased DTR
spasms
clonus
Babinski

Question 24

How does a MS pt’s coordination and balance affected?

Answer 24

ataxia
dysmetria
dysdiadochonkinesia
postural & intention tremors

Question 25

What are some common S&S for MS?

Answer 25

Fatigue

Pathogenesis (physical & mental energy decrease)

Question 26

What outcome measure is used to Quantify disability in MS?

Answer 26

EDSS (expanded disability status score)

Question 27

How many functional systems are tested in EDSS?

Answer 27

8

Question 28

What is the 0-10 score in EDSS?

Answer 28

0: normal
10: death due to MS

Question 29

What other standardized assessment can be used for MS?

Answer 29

TUG
MS walking scale (higher the score more disabled)
Berg balance

Question 30

What are some medications for MS?

Answer 30

none no sure, only to decrease edema and damage to myelin