MS and MND

Question 1

What is multiple sclerosis?

Answer 1

Neurological condition autoimmune destruction of myelin sheath of neurones in CNS

• loss of myelin sheath - demyelination

Aetiology unknown - genetic/environmental factors likely

Neurological signs and symptoms disseminated in time and site

Question 2

Where in the world is MS most common?

Females or males?

Age of onset?

Answer 2

Most common near the poles of the earth

• women > men
• mean onset age 30 years

Question 3

What are the clinical features of MS?

Answer 3

Depends of area of demyelination

• loss of vision in one eye, double vision (optic neuritis)
• changes in sensation
• ataxia
• weakness

Initial recovery is common

Question 4

What are the two types of MS disease?

Answer 4

Relapsing/remitting:

• different areas affected at different times
• partial/complete recovery in between
• increasing treatment options in this variant

Chronic/progressive

• cumulative damage

Question 5

How is MS diagnosed?

Treated?

Answer 5

Diagnosis:

• clinical, lumbar puncture, MRI scan mainstay

Treatment:

• high dose steroids in acute relapse
• disease modifying drugs reduce relapses and slow progression of disability in relapsing remitting disease e.g. betaferon, glatiramer

Ongoing disease:

• rehabilitation and supportive care, specialist nurses
• support for independent living and for carers

Question 6

What is Motor Neurone Disease?

List some clinical features:

Answer 6

MND - destruction of motor neurones - cause unknown

Clinical features:

• limb weakness
• swallowing problems
• respiratory muscle weakness

Question 7

How is MND diagnosed?

Treatment?

Prognosis?

Answer 7

Diagnosis:

• clinical, neurophysiology

Treatment:

• medication - limited value
• mainly supportive - feeding tubes, mobility aids, couh assist, communication aids, high levels of care in later stages of illness

Prognosis - usually <5yrs so support from specialist nurse, neurologist, GP, palliative care for pt and family is required