MS- Multiple Sclerosis

Question 1

What is MS?

Answer 1

Immunological/ neurodegenerative disease

Immune system attacked the myelin sheath around the brain, spinal cord and optic nerve (demyelination)

Chronic inflammation

Diffuse myelination to white/ gray matter and axons

Formation of plaques (scar tissue formation that reduces impulse conductivity)

Question 2

What is the hypothesis of MS etiology?

Answer 2

Genetics (polygenetic) + environmental factors

Smoking

Lack of UV light exposure results in vitamin D deficiency

Question 3

What viral infections can cause MS?

Answer 3

Mononucleosis

Epstein- Barr

Question 4

Most common nontraumatic neurodegenerative disorder among people under the age of …?

Answer 4

40

Question 5

What percent of the US population has MS?

Answer 5

1%

Question 6

Where in the world are you less likely to have MS?

Answer 6

Near the equator

Question 7

Does MS affect men or women more?

Answer 7

Women

Question 8

True or false:

Scandinavian/ Scottish decent is more susceptible to MS

Answer 8

True

Question 9

How many times more likely is MS in caucasians?

Answer 9

2x

Question 10

What are the signs and symptoms of MS?

Answer 10

Fatigue- MOST COMMON

Motor, sensory, visual, and autonomic systems affected

Diplopia

Dysesthesia/ paresthesia- sensation

Erectile dysfunction

Gross/ fine motor incoordination

Cognitive deficits

Depression/ euphoria

Loss of visual acuity (80%)

Spasticity

Dysphagia

Vestibular dysfunction

Question 11

Between what age is MS diagnosed in?

Answer 11

20-40

Question 12

What age does onset peak?

Answer 12

30

Question 13

What age is MS not common to be diagnosed after?

Answer 13

60

Question 14

What are the 4 types of MS?

Answer 14

1) clinically isolated syndrome (CIS)
2) relapsing- remitting MS (RRMS)
3) secondary progressive MS (SPMS)
4) primary progressive MS (PPMS)

Question 15

What is clinically isolated syndrome (CIS)?

Answer 15

Refers to 1st episode of neurologic symptoms that lasts at least 24hrs and is caused by inflammation Or demyelination

Can be either monofocal or multifocal

May or may not process to MS

If accompanied by MRI findings may be diagnosed with MS

Accurate diagnosis is important so that disease modifying therapy can start to prevent onset of MS

Question 16

What is relapsing- remitting MS (RRMS)?

Answer 16

Most common form

Clearly defined attacks of new or increasing neurologic symptoms

Relapses followed by periods of partial or complete remission

Active/ non active- relapse and/ or evidence of new MRI activity

Worsening/ not worsening- confirmed increase in disability over a specified period of time following a relapse

Question 17

What is secondary progressive MS (SPMS)?

Answer 17

Most people with RRMS eventually transition to SPMS

progressive worsening of neurological function

Active/ non active

With progression/ without progression- evidence of disease worsening on an objective measure of change over time (EDSS)

Question 18

What is primary progressive MS (PPMS)?

Answer 18

Worsening neurological function and accumulating disability without early relapses or remissions

Active/ non active

With progression/ without progression

Approximately 15% ppl diagnosed with MS have this

Involved less inflammation than other forms of MS

Fewer brain lesions (plaque)

More lesions in the spinal cord

More difficult to diagnose and treat than relapsing forms of MS

Question 19

True or false:

10 years post diagnosis 10% of ppl are wheelchair bound and 50% are unable to work

Answer 19

True

Question 20

If MS diagnosis is in your 20s, when is the prognosis?

Answer 20

46-60 years

Question 21

If MS diagnosis is in your 60s, when is the prognosis?

Answer 21

13-22 years

Question 22

What are MS medical/ surgical managements?

Answer 22

Disease modifying drugs

Beta-blockers

Anticholinergics

Antidepressants

Steroids

Cannabis extract

Cognitive rehabilitation

OT/ PT

Bone marrow transplants

Low impact exercise

Healthy diet