MS Flashcards
What are the varying types of fatigue in patients with MS?
Primary Fatigue and Secondary Fatigue
Primary = motor fatigue (worsens as activity progresses, and progressive decrease in motor output), lassitude - unique to MS, global fatigue (worsens throughout the day, worsened by heat, comes on suddenly).
Secondary = due to being sedentary, pain, compensation, infex, depression, sleep disorder (can be helped by PT)
What is the uthoff phenomenon?
heat sensitivity
What is Lher-mittes syndrome?
flexion of the neck and some shocking pain that can go into the LE.
What meds are commonly used by patients with MS and what are they for?
general inflammation: steroids CRAB drugs: actually slow disease progression difficulty walking / strength: ampyra spasticity: baclofen bladder issues: urgency med ditropan bowel dysfx: stool softener
What is the EDSS?
Expanded Disability Status Scale - largely linked to walking / mobility for diseases that progress. 4 is the cut off for being able to walk with no AD.
What is typical treatment like for patients w/ MS?
- Acute exacerbations - managed by high dose meds (steroids)
- Sx mgmt
- disease modification
- rehab (to enhance / maintain phys fx)
- psychosocial support
When is typical onset for MS and what are the differences between the disease’s presentation in males vs. females?
onset is typically before 35.
Females usually have a single region of the CNS involved and recover fully after exacerbation - they also generally have an easier time of it in general.
Males usually have a tougher time and brainstem sx (nystagmus, tremor, ataxia, dysarthria) and have more frequent exacerbations.
What is one of the common first sx that patient w/ MS will present with?
optic neuritis - inflammation of the optic nerve which may manifest as diplopia and nystagmus
What are some common sx of MS?
MOST COMMON:
Fatigue, heat sensitivity, weakness (difficulty walking), stiffness and spasms
LESS COMMON:
Bladder, memory/cognition, pain, major depressive episode (at some point)
What is the difference between relapsing-remitting, primary progressive, secondary progressive, and progressive relapsing MS:
Relapsing-remitting: exacerbations happen but usually return to baseline occurs.
Primary progressive: steady progression throughout lifetime without dramatic exacerbations.
Secondary progressive: exacerbations @ initial point of disease followed by a long duration of slow progression.
Progressive relapsing: more rare, very serious spikes but continual decline.
When is a definitive dx for MS able to be made?
When MRI shows multiple plaques in at least two discrete areas.
What is the disease process occurring in a patient with MS?
Demyelination until the axon is fully destroyed.
Oligodendrocytes are myelin producing cells in the CNS which are also eventually destroyed.
What pathophys structures does MS effect?
Brain, CNS, optic nerves
What systems review will you complete in your exam of a patient w/ MS?
- Cardiopulm
- Integumentary
- MSK - problems due to disease or due to compensations?
- Neuro - spasticity, reflexes, sensation, vision, vestibular
- Behavior and communication
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Functional mobility
What is MS Edge?
A guideline for outcome measures for patients w/ MS
