MS

Question 1

What is MS?

Answer 1

MS is a chronic demyelinating disease of the CNS, characterised by an inflammatory process. Causes widespread degeneration of the CNS. Results in severe neurological deficit.

Question 2

How does MS occur?

Answer 2

There is a disruption in the blood-brain barrier which allows inflammatory cells to leak out. These cells then attack the oligodendrocytes (which myelinate the axons) and myelinated sheath. When these become damaged, nerve impulses become slower.

Plaques form throughout the CNS - Sclerosis.

Question 3

Possible causes of MS?

Answer 3

• Infection
• Vaccination
• Pregnancy
• Environmental factors
• Lack of Vitamin D

Question 4

Diagnosis of MS?

Answer 4

• Extensive clinical history
• Lumbar puncture to test cerebrospinal fluid
• Nerve conduction tests
• MRI scan

Question 7

Medical Treatment of MS?

Answer 7

• Anti-Spasticity medication - Baclofen and Tizanidine
• Pain relief - analgesics
• Anti-depressants
• Diet - more fish oils and vitamin D (food, supplements, sunlight)

Question 8

Prognosis of MS?

Answer 8

Difficult to predict, depends on type of MS.

Earlier age at diagnosis favours a slower onset of progression.

Question 9

Outcome measures of MS?

Answer 9

• Expanded Disability Status Scale
• Impact on Daily Life
• Balance
• Functional Reach

Question 10

Types of MS

Answer 10

• Silent/Benign
• Relapse Remitting (relapse must last at least 24 hours)
• Secondary Progressive
• Primary Progressive

Question 11

Signs and symptoms of MS?

Answer 11

• Visual problems - Optic neuritis (inflammation that damages the optic nerve), diplopia (double vision)- VISUAL CORTEX (OCCIPITAL LOBE)
• Vertigo - VESTIBULAR SYSTEM
• Limb weakness - MOTOR CORTEX (FRONTAL LOBE)
• High tone - ALPHA MOTOR NEURON
• Poor balance - VESTIBULAR SYSTEM/CEREBELLUM
• Ataxia (uncoordinated movement)- 3 types cerebellum, sensory & vestibular
• Fatigue
• Loss of sensory function - parasthesia -SENSORY CORTEX (PARIETAL LOBE)