Multiple sclerosis Flashcards
What is MS?
a chronic demyelinating disease of the CNS characterised by an inflammatory process and causing widespread degeneration of the CNS, gradually resulting in severe neurological deficit
What 4 main thigs happen in MS?
disruption of blood-brain barrier
leakage of inflammatory cells
destruction of oligodendrocytes and myelin sheath
disruption of nerve signals, rate of conduction of nerves is slowed down
What do oligodendrocytes do?
myelinate axons in the CNS
name some suspected triggers of MS
environmental factors
-occurs more frequently in areas further from the equator
- low vitamin D levels
-smoking
obesity in childhood and adolescence particularly in girls
viral factors
Genetic factors
-200 genes identified that contribute to developing MS
Is MS an inherited disease?
no
At what age are people with MS generally diagnosed?
20-40 years of age
Name 4 types of MS
Benign MS
Relapsing remitting MS
Secondary progressive MS
Primary progressive MS
Name some of the most common signs and symptoms of MS
fatigue
difficulty walking
vision problems, such as blurred vision (often coming from optic neuritis)
problems controlling bladder
sensory deficits
increased muscle tone
reduced balance
ataxia
problems with thinking, learning and planning
What area is potentially damaged if a patient with MS has vision deficits?
occipital lobe, optic nerve, thalamus
What area is potentially damaged if a patient with MS has weakness?
motor cortex, descending pathways
What area is potentially damaged if a patient with MS has spasticity and hyperreflexia?
motor cortex, descending pathways
What area is potentially damaged if a patient with MS has ataxia and poor coordination?
cerebellum
What area is potentially damaged if a patient with MS has sensory loss?
sensory cortex or ascending pathways
What area is potentially damaged if a patient with MS has dizziness or poor balance?
vestibular system or cerebellum
What area is potentially damaged if a patient with MS has sphincter disturbance?
spinal cord
What area is potentially damaged if a patient with MS has sexual dysfunction?
spinal cord
What area is potentially damaged if a patient with MS has mood problems?
limbic system, dopamine system, hypothalamus
What area is potentially damaged if a patient with MS has decreased intellectual function?
frontal lobe
What area is potentially damaged if a patient with MS has fatigue?
complex
How long does a diagnosis for Ms take?
several months or more because no single test can conclusively diagnose
What 6 events have to occur for somoene with Ms to have had a relapse?
clinical event of the type usually seen by MS
event must last at least 24 hours
objective findings must be present
the event is not a temporary worsening entirely due to fever or infection
to count as a distinct (new) attack, the onset of a clinical event must be at least 30 days after the onset pf any prior attack
a single paroxysmal episode does not constitute a relapse, but multiple paroxysmal events occurring over 24 hours or more can equal an attack
What does treatment for a relapse of MS involve?
5-day course of steroid tablets taken at home
or
injection of steroid medicine given in hospital for 3-5 days
What do steroids do?
reduce inflammation
What are the main benefits for taking disease modifying drugs for MS?
fewer relapses
less severe relapses
reduce build up of disability which can occur if recovery isn’t complete form relapses
Nam some anti-spasticity agents and relaxants
baclofen
tizanadine
canabis
Name some medicines used for neuropathic pain
gabapentin
pregabalin
amitriptyline
carbamazepine
Name some factors that are associated with a relatively better disease course
being female
being less than 40 years old when diagnoses
having fewer relapses in the first few years after diagnosis
making a complete recovery from relapses
having long intervals between relapses
having symptoms that are mainly sensory in nature
Who will be involved if an MS patient has difficulty walking?
physio
OT
Who will be involved if an MS patient has vision problems?
ophthalmologist
MS nurse
OT
Neurologist
Who will be involved if an MS patient has bladder problems?
MS Nurse
Continence nurse
Who will be involved if an MS patient has sensory deficits?
Physio
OT
MS Nurse
Neurologist
Who will be involved if an MS patient has spasticity?
Physio
OT
Neurologist
Who will be involved if an MS patient has balance problems?
Physio
Who will be involved if an MS patient has ataxia?
Physio
OT
Who will be involved if an MS patient has problems with thinking, learning and planning?
OT
Neuro Psych
MS nurse
Who will be involved if an MS patient has sexual dysfunction?
MS Nurse
Who will be involved if an MS patient has mood problems?
Neuro Psych
MS Nurse
Who will be involved if an MS patient has swallowing difficulties?
speech and language therapist
Dietician
