MS pt. 2 Flashcards
relapsing remitting MS (RRMS)
clear defined episodes of neurologic function followed by partial/complete recovery, with periods of time btw that pt’s are clinical free of disease progression
secondary progressive MS (SPMS)
can progress to this
initially presents as RR period followed by a steady worsening of neurologic fxn, with or without relapses
what do remissions look like with SPMS
minor or can have plateau
continue to get worse
can get missed
primary progressive MS (PPMS)
continuous worsening from initial onset without distinct relapses or remission
may have occasional plateaus and temporary minor improvements
acute exacerbation treatment
immunosuppressant drugs
prednisone, methylprednisone, adrenocorticotropic hormone (ACTH)
what drugs are disease modifying
interferon drugs
copaxone
tysabri
novantrone
what do disease modifying drugs do
reduce frequency and severity of:
clinical attacks
reduce development of lesion sites
slow down the progression of disability
what do interferon drugs do
slow progression and decrease symptoms
side effects of interferon drugs
flu like symptoms
depression
abdominal pain
injxn site pain
leukopenia
dosage for interferon drugs
daily
3x week
or weekly
dosage for copaxone
daily subcutaneous injxn
how does copaxone work
synthetic protein designed to mimic effects of myelin protein
side effects of copaxone
flu symptoms
N/V
joint pain
visual disturbances
weakness
edema in hands and feet
what systems does the expanded disability status scale look at
pyramidal
cerebellar
brainstem
sensory
bowel/bladder
visual
cerebral
other neurologic findings
normal to mild disability for EDSS
0-3.5
mild to moderate disability for EDSS
4-5.5
mod to severe disability for EDSS
6-7.5
severe disability with restriction to bed or WC for EDSS
8-9.5
EDSS 0-4.5 clinical symptoms
no symptoms to mild to mod:
fatigue
unsteadiness/imbalance
sensory changes
mild walking impairments
reduced visual acuity
bowel/bladder symptoms
altered mood state
cog impairment
EDSS 0-4.5 neurologic impairments
ranging from normal neurologic exam to mild-to-mod impairments in:
proprioception
cerebellar fxn
vision
muscle strength/tone/endurance
bladder fxn
cognition
EDSS 0-4.5 functional limitations
ranging from no limitations to limited:
endurance
unsteadiness
impaired information processing and memory
EDSS 5-6.5 symptoms
progression of any or all symptoms seen in 0-4.5
EDSS 5-6.5 neurologic impairments
any symptoms mentioned with EDSS 0-4.5 plus:
worsening gait and UE coordination
EDSS 5-6.5 functional limitations
limited walking distance 20-200m
falls
inability to safely complete dual motor/cognitive tasks
adaptive equipment at work/home
compensatory strategies
mobility aids
challenging transfers
requires assistance from support partner for more complex daily activities
EDSS 7-9 symptoms
continued worsening gait of all symptoms mentioned with other levels
EDSS 7-9 neurologic impairments
continued worsening symptoms mentioned with other levels
EDSS 7-9 functional limitations
gait - 10ft w walker
transfers - minimal assist to total
bed mobility - minimal assist to total
seated balance - independent to total assist
standing balance - ind w bilateral support to unable to stand unaided
