Multiple Sclerosis Flashcards
MS definition
Chronic inflammation disease causing demyelination in the CNS
Scarring on the myelin sheath
Categories of MS
Relapse-remitting MS
Primary-progressive
Secondary-progressive
Progressive-relapse
Exacerbating factors
Relapse )at least 24 hrs)
Aggravating factors
- viral infections
-Bacterial infections
-disease of major systems
- emotional and bodily stress
Pseudoexacerbation (last <24hrs)
- Uhtoffs phenomenon, adverse reaction to heat
S&S
Depends on where in the brain it is being effected
Sensory changes
Pain (worse at night)
Visual changes
Motor dysfunction (central nervous system fatigue)
Speech and swallowing dysfunction
Cognitive and affective changes
Autonomic changes
Lhermitte’s sign
Neck flexion caused pain down the spine
Pseudobulbar effect
Sudden and unpredictable mood changes
Diagnosis
MRI
Blood work to rule out other conditions
Interventions
medical
- disease modification agents (long term)
- corticosteriod therapy (during relapse)
- medication for symptoms (depending on the presenting symptoms)
Physical therapy management
- dependent on presenting symptoms
- exercise has overall good benefits for MS (take fatigue and overheating into consideration)
Exercise consideration
To avoid and consider heat intolerance
- in the morning
- in cool environments
- keep hydrated with cool liquids
- wear light, loose clothing with good ventilation
- blowing fans
- avoid hot baths
- use submaxima exercise intensities
- take more rest intervals
- do not overwork patients
Management of fatigue
Considered the most debilitating symptom
Diurnal: least in the morning, worse in the afternoon
Activity dairy to see where the triggers are and will help with creating strategies
Corticosteroid therapy- use and side effects
shortens the duration of MS exacerbation episodes and has a powerful anti-inflammatory effect.
Side effects include: mood changes, increased blood pressure, fluid retention, acne, insomnia, and hyperglycemia.
