Multiple Sclerosis Flashcards
Define Multiple Sclerosis
Autoimmune disease that involves demyelination of the corticospinal tract neurons in 2 or more regions of the brain and spinal cord.
Multiple Sclerosis: Who is usually diagnosed?
Young adults (20-45 years)
Multiple Sclerosis: Female to male ratio
2:1 F:M
Multiple Sclerosis: Characterizations
Characterized by multiple motor and sensory disturbances
Multiple Sclerosis: What are the four types?
- Relapsing/Remitting
- Primary Progressive
- Secondary Progressive
- Progressive Relapsing
Multiple Sclerosis: Common Presenting Symptoms
Optic neuritis, weakness and/or parasthesias in one or more extremities, unsteadiness of a leg or hand, fatigue, impaired coordination, tremor, spastacity, ataxia, pain
Multiple Sclerosis: Sympatoms present as _____ and ____
Attacks and relapses
Multiple Sclerosis: Visual Disturbances
Vision problems, blindness, abnormal eye movements
Multiple Sclerosis: Motor Disturbances
Muscle weaknesses, affect walking and use of hands, bowel and bladder incontinence, spastic paresis of skeletal muscles
Multiple Sclerosis: Sensory Disturbances
Loss of touch, pain to temperature, proprioception, parasthesias of the face (can precede the onset of other symptoms by several years)
Multiple Sclerosis: What occurs in 2-4% of Multiple Sclerosis patients?
Trigeminal neuralgia
Multiple Sclerosis: When does fatigue occur the most often?
In the afternoons
Multiple Sclerosis: What are the anti-inflammatory medications used for medical management?
- IV corticosteroid
- Interferon beta-1a
- Interferon beta-1b
- Natalizumab, ustekinumab, rituximab
- Glatiramer, acetate injection
- Mitoxantrone
Multiple Sclerosis: What are IV corticosteroids used for?
Acute attacks
Multiple Sclerosis: What is Mitoxantrone used for?
Aggressive disease
Multiple Sclerosis: What drugs are used to manage complications?
Balofen, benzodiazepines, dantrolene, tizanidine, oxybutynin, anti-anxiety, anti-depression, medications for chronic pain
Multiple Sclerosis: As dentists, what symptoms are we looking for in order to refer to neurologist?
-Abnormal facial pain (like Trigeminal neuralgia), numbness in the extremities, visual disturbances, muscle weakness, young patient
Multiple Sclerosis: What kind of dental care should be given to patients experiencing a relapse?
Emergency care only
Multiple Sclerosis: What kind of dental care should be given to patients in remission?
This is the optimal time to treat
Multiple Sclerosis: Dental Modifications for stable disease
No significant dental modifications needed
Multiple Sclerosis: Dental Modifications for Advanced diseases
May need help to transfer patient to chair, patient may have difficulty with oral hygiene, avoid reconstructive, prosthetic procedures
Multiple Sclerosis: When should appointments be scheduled?
In the morning
Multiple Sclerosis: What is a common symptom caused by medication management in these patients?
Xerostomia
Multiple Sclerosis: What types of palliative care can counsel for patients with xerostomia?
-Rinses, gels, hydration, dry mouth lozenges
Multiple Sclerosis: What two systemic drugs can be considered for xerostomia?
Pilocarpine and Cevimeline
Multiple Sclerosis: What are some oral manifestations that can occur in these patients?
- Dysarthia
- Parasthesia
- Numbess of the orofacial structures
- Trigeminal Neuralgia
Multiple Sclerosis: Define Dysarthia
Slow, irregular speech with unusual separation of syllables of words
