Multiple Scerosis Flashcards
what is MS
auto-immune disease of CNS which causes de-myelination of the myelin sheath around nerve axons, leading to the impairment of electrical signals
what are the 4 types of MS
- relapse - remitting
- secondary progressive
- primary progressive
- benign
describe relapse - remitting MS
symptoms occur then virtually completely resolve
describe secondary progressive MS
- developed after relapse-remitting
- incomplete recovery of symptoms and cumulative loss of function and disability
describe primary progressive MS
- progressive onset of symptoms with no relapses
describe benign MS
- defined as low disability 10 years after onset
- may still progress to have major disability
describe the pathophysiology of MS
recurrent CNS inflammation results in damage to the myelin sheth surrounding nerve axons as well as the axons themselves.
- also causes a reduction in oligodendrocytes which are responsible for the myelination of the CNS
what is the suspected reason for inflammation of the CNS
autoimmune response against CNS antigens
describe the autoimmune response against CNS antigens to cause inflammation of the CNS
- T cells are acitvated by an unkown cause an migrate across the blood brain barrier into the CNS
- T cells then react with local CNS antigens
- this then secretes proinflammatory cytokines and palsma cells secrete antibodies against myelin leading to its destruction
- ongoing inflammatory process in the CNS recruits additional inflammatory cells
- activated microglia release free radicals, nitric oxide and proteases which further contribute to damage and axonal loss
what are common early symptoms of MS
- pathcy numbess
- weakness
- visual disturbance
- fatigue
what are some common central symptoms of MS
- fatigue
- congnitive impairment
- depression
- unstable mood
what is diplopia
double vision
what is ataxia
a group of disorder that affect coordination, balance and speech
what ar common visul symptoms of MS
- nystagmus
- optic neuritis
- diplopia
what is nystagmus
rhythmical, repetitive and involuntary movement of the eyes
what is optic neuritis
inflammation of an optic nerve, causing blurred vision.
what is a common speech symptom of MS
dysarthria
what is dysarthria
where you have difficulty speaking because the muscles you use for speech are weak.
what is a common symptom of the throat for MS
dysphagia
what is dysphagia
difficulty or discomfort in swallowing, as a symptom of disease.
what are some common symptoms of the muskuloskeletal system of MS
- weakness
- spasms
- ataxia
what are some common sensational symptoms of MS
- pain
- hypoesthesia
- paraesthesia
what hypoesthesia
a symptom that involves extreme sensitivity in your sense of touch.
what is paraesthesia
sensation of tingling, burning, pricking or prickling, skin-crawling, itching, “pins and needles” or numbness on or just underneath your skin.
what are some common symptoms of the bowels of MS
- incontinence
- diarrhea
- constipation
what are some common symtoms affecting the unrinary system of MS
- incontinence
- frequency
- retention
what are some ways in which MS is diagnosed
- via a lumbar punture for CSF analysis: increase in gamma globulin and presence of oligoclonal glands
- via an MRI: T2 signal chnages, white matter abnormalities, contrast to show active inflammation
what are some medications that help manage MS
- anti-inflammatory steroids
- immunotherapy: interferon (helps fight infection), dimethylfumarate (modulates immune respone to be less inflammatory
- stem cell transplants
what is the role of physiotherapy in helping MS patients
- symptom specific management e.g. muscle tone, incontinence, mood
- pacing strategies and fatigue management
- falls prevention
- family support
- education
- increase independence
- aids and adaptions
- onwards referral for long term conditions
- improve mobility