Multiple Sclerosis Flashcards
what is multiple sclerosis?
Chronic, inflammatory disorder causing demyelination & axonal injury
T/F Multiple sclerosis has remissions and exacerbations
True
What is lhermitte’s sign?
an electrical shock like sensation that runs down the back or limps upon flexion of the neck
what are some symptoms of MS?
sensory in limbs visual loss motor diplopia gait disturbance balance problems sensory in face vertigo bladder problems lhermitte sign pain acute transverse myelopathy pain polysymptomatic onset
What are some diagnostic tests for Ms?
MRI to reveal lesions
Evoked potential test to measure nerve sensations
Lumbar puncture to check for increased WBC’s or proteins
what assessments should you conduct on a patient suspicious of MS?
Medical history, and in depth neuro exam
including gait, posture, coordination, balance
what patterns are required for diagnosis?
- Two or more episodes of exacerbation (separated by 1 month, lasting longer than 24 hours with subsequent recovery)
- or clinically defined exacerbations & remissions with or without complete recovery, followed by progression of sx over a period of at least 6 months
- or slow and stepwise progression of s and sx
what are three goals of therapy of MS?
- modify the disease process
- treat acute relapses
- manage symptoms
what are some non-drug interventions?
PT– strengthening exercises, mobility assistance
Counseling– coping strategies for patient and family
what are some teaching points for patients?
Self care:
recognize triggers (infection, trauma, stress, change in environment)
-rest
-exercise (regular aerobic)
-avoid extreme heat, keep environment cool (tepid/cool baths)
-well balanced diet, keeps immune system strong
-maintain normal activities
-stay connected
-pursue hobbies
-join support group
-maintain physical health as much as possible
pre-procedure for lumbar puncture
- prior to procedure, empty bladder
- lateral recumbent position in fetal position
- tilt table
- consent form
patient positioning for lumbar puncture
- may or may not be required to lay flat for 1 hour after procedure
- no evidence to support notion of longer bed rest = less headache
what to monitor with lumbar puncture
monitor for spinal headache
–bed rest & analgesics– including opioids
moderate to severe pain:
blood patch and IV caffeine
what is an evoked potential test
detection electrodes place on scalp, neck, and back
responses to stimulation are recorded
Visual evoked potential test
-sits before a screen in which a checkerboard pattern is displayed to assess visual changes associated with MS
