MS

Question 1

What is MS?

Answer 1

It is a chronic, degenerative, progressive demyelination of nerve fibers in the white matter of the CNS.

Question 2

Who are at high risk for MS?

Answer 2

Women
Caucasian & North European descent
Family Hx
Lack of Vit D
Heavy smoker
Epstein Barr Virus

Question 3

What are early s/s?

Answer 3

Extreme fatigue
Parathesias
Dysethesias (nerve pain, achy, burning, facial pain)
Lhermitte’s Sign-“electric sensation in back & legs”
Balance/coordination probs
Blurring, visual field loss, diplopia, pain with eye movement, blindness, nystagmus
Urinary urgency or hesitancy

Question 4

What are late s/s?

Answer 4

Emotional liability (up/down mood swings)
Bladder, bowel, and sexual dysfunction
Spastic Paralysis of extremities, trunk
Contracture deformities
Intention tremors with activity
Memory loss
Cognitive changes
Death

Question 5

What are the diagnostic tests?

Answer 5

2 or more episodes separated by 1 mo.
MRI- 2 or more lesions
CSF- thru LP analysis show abnormal cells or antibodies
Evoked potential studies- EEG eval pathways & response time of nerves

Question 6

What meds are used to tx?

Answer 6

Immunomodulators

Immunosuppressants for relapses

Question 7

What are interventions for fatigue?

Answer 7

Conserve energy
Avoid extreme temps
Mobility aids
Less-moderate exercise

Question 8

What meds are used to manage fatigue?

Answer 8

Antidepressants like Prozac, Elavil, or Pamelor

Question 9

What meds are used to manage spasticity?

Answer 9

Muscle Relaxants:
Baclofen PO or intrathecal pump
Zanaflex/tizanidine
Dantrium/dantrolene
Valium/diazepam

Question 10

What are interventions for spasticity?

Answer 10

Exercise, stretching, adaptive equipment

Question 11

What meds are used to manage pain?

Answer 11

NSAIDs for musculoskeletal pain
Anticonvulsants for neuropathic pain (Neurontin, Tegretol)
Tricyclic antidepressants for neuropathic pain (Elavil)