Multiple Sclerosis Flashcards
1
Q
Pathophysiology
A
autoimmune related inflammatory disease of the CNS
- inflammation
- demyelination
- causes glisosis (scarring) and plaque formation at the site of destruction
- results in axonal loss and inability of the nerve to transmit electric signals
2
Q
Sub-Groupings
A
Primary progressive - 10%
- continuous worsening of symptoms
- no distinct relapse
Relapsing Remitting - 85%
- episodes of clearly defined relapse followed by a period of recovery
- don’t necessarily regain full function
Secondary Progressive - 50-70%
- usually develops from RRMS
- develops into progressive forms, fewer recovery
Progressive Relapsing - 5%
- progresive
- clear acute relaspes that may or may not resolve
- continual progression between relapses
3
Q
Motor Symptoms
A
fatigue - severe generalised tiredness - worsened by heat - require more effort to complete everyday tasks - eventually become deconditioned - effects of depression and medication spasticity weakness and loss of motor control cerebellar and brainstem signs gait disturbances
4
Q
Sensory Symptoms
A
numbness pain paraesthesia loss of proprioception distortion of superficial sensation
5
Q
Visual Symptoms
A
monocular blindness diminished acuity blurred vision double vision ocular pain oscillopsia due to vestibular/cerebellar involvement
6
Q
Bladder/Bowel Symptoms
A
urgency frequency incontinence urinary retention constipation
7
Q
Cognitive and emotional symptoms
A
depression lability memory disturbances diminished conceptual thinking decreased attention and concentration
8
Q
Speech and swallowing
A
dysarthria
dysphagia
9
Q
Diagnosis
A
evidence of a history of lesion of 2 or more sites with at least one month between them
MRI identification of lesion
CSF - increased antibody production
10
Q
General Assessment
A
expanded disability status scale
outcome measures appropraite for patient’s individual impairment
11
Q
Treatment
A
immunomodulation to dampen the inflammatory activity steroids to reduce inflammation symptomatic management fatigue management involvement in MS society involve MDT
12
Q
Physio Assessment
A
look at fatigue pattern and its impact sensory and motor assessment cranial nerve function functional mobility balance respiratory function continence pain
13
Q
Physio Management
A
depends on assessment findings fatigue management and education management of muscle shortening strengthening and endurance training functional mobility coordination and dexterity exercises fitness and conditioning improve sensory input chest and respiratory management appropriate positioning teach self management and faciliate independences - HEP - MS society - community groups prevent and manage secondary complications early treatment
14
Q
Prognosis
A
depends on type of MS
will likely all get to end stage - just varying times
