MS Flashcards
what is multiple sclerosis?
is a chronic, progressive, degenerative autoimmune disorder of the CNS characterised by disseminated demyelination of nerve fibres of the brain, spinal cord, and optic nerve
what country has the highest rates of MS in the world?
Canada, especially Alberta
where does MS have high prevalence?
high rates in areas with temperate climates (low areas of sunlight - vitamin D)
-more prevalent in women
onset of MS?
15-50 years old
what is the cause of MS?
unknown
possible precipitating factors of MS?
infection, trauma, emotional stress, excessive fatigue, pregnancy, and state of poor health
what is MS characterized by?
characterised by chronic inflammation, demyelination and scarring of the CNS
what is attacked in MS?
-the disease process consists of loss of myelin, initially the myelin sheaths of the neurons in the brain and spinal cord are attacked
what do MS pts complain of?
weakness, but however the myelin can regenerate itself and symptoms disappear, resulting in a remission
motor symptoms of MS?
- symtoms occur over month
- motor symptoms include: paralysis of the limbs, trunk, or head, diplopia, spasticity of the muscles
sensory symptoms of MS?
- sensory abnormalities: numbness and tingling, blurred vision, vertigo, chronic neuropathic pain
- decreased hearing, ringing in ears
why do pts experiance fatigue?
severe fatigue- associated with increased energy needs, decondition, depression and medication adverse effects
what is Lhermittes sign?
a transient sensory symptom described as an electric shock radiating down the spine or into the limbs with flexion of the neck
what are some cerebellar signs?
nystagmus- rapid involuntary movements of the eyes.
ataxia-the loss of full control of bodily movements.
dysarthria-difficult or unclear articulation of speech-
dysphagia
bowel/ bladder symptoms?
- function can be affected if the sclerotic plaque is located in the area of the CNS that control elimination
- problems with defecation
- constipation
- fecal incontinence
- spastic bladder leading to urinary urgency and frequency and results in dribbling or incontinence
diagnostic for MS?
- no diagnostic studies, very hard to diagnose
- diagnosis is often based off history, clinical manifestations and the presense of multiple lesions over time as measured by MRI
- no blood test
what is the goal of therapy?
-slow disease progression
drugs for exacerbations?
-steroids like methylprednisolone are used for acute exacerbations
drug used for relapsing-remitting MS?
interferon B (bettaseron)
what is a new promising drug for MS?
Natalzumab (Tysabri)
-works by inhibiting the migrations of lymphocytes thus decreasing the inflammatory process and prevent further damage to the myelin
alternative therapy?
- neurological dysfunction can improve with physiotherapy and speech therapy
- excersise improves pts who are not experiencing a current exacerbation
- megavitamin therapy (vitamin B12, C, and D)
- diet consisting of low-fat, gluten free food and raw veggies
how can excersise help a pt with MS?
- it decreases spasticity, increases coordination, and retrains unaffected muscle to substitute for impaired ones
- water excersise is very beneficial
Overall goals for MS pts?
- maximize neuromuscular function
- maintain independence in activities of daily living for as long as possible
- manage disabling fatigue
- optimize psychosocial well-being
- adjust to illness
- reduce factors that precipitate exacerbations
what are exacerbations of MS triggered by?
- infection (especially upper resp infections and UTI’s)
- trauma
- immunizations
- childbirth
- stress
- change in climate
