Multiple Sclerosis

Question 1

what is the average age of MS onset?

Answer 1

20 - 40 years old

Question 2

what sex does MS affect more?

Answer 2

2x more likely in females

Question 3

what is the etiology of MS?

Answer 3

Unknown, thought to be an autoimmune disease triggered by a viral infection in genetically susceptible individuals

Question 4

what causes MS?

Answer 4

Build-up of white matter plaques in the brain and spinal cord (CNS)
Disrupts neuronal transmission
Recent evidence of axonal damage

Question 5

how common is MS?

Answer 5

Most Common non-traumatic neurologic illness affecting young and middle aged adults

1 of most common causes of Neurologic DISABILITY in young adults

Question 6

how does MS get its name?

Answer 6

demyelination is often followed by sclerosis, or hardening of nervous system tissue, usually at multiple sites

gliosis = result of scar tissue forming in the central nervous system

Question 7

what is the genetic component of MS?

Answer 7

Risk increases with 1 effected first degree relative

identified genes associated with risk of getting MS appear to involve immune system functions

Question 8

what are the factors affecting MS?

Answer 8

Pregnancy decreases exacerbations
Postpartum risk increases for 3 months
Infections increase symptoms and may trigger new lesions

Question 9

what are the disease courses?

Answer 9

relapsing remitting
secondary progressive
primary progressive

Question 10

what are the MS Symptoms at Onset?

Answer 10

CNS fx can be effected

1/3 start with sensory changes, visual symptoms, and motor changes

Vague transient symptoms may lead to a delay in diagnosis

Question 11

what is Optic neuritis?

Answer 11

Impaired vision due to optic nerve which is Myelinated by oligodendrocytes

Question 12

what is Internuclear Ophthalmoplegia?

Answer 12

extraocular muscle weakness

Question 13

what is Partial myelitis?

Answer 13

involving spinal cord inflammation

Question 14

what is Neurogenic bladder?

Answer 14

overactive or underactive bladder

Question 15

what does Trigeminal neuralgia cause?

Answer 15

sensory and motor deficits of the face

Question 16

how are MS patients heat sensitive?

Answer 16

worsening of sxs with increased body core temp (extreme heat)

Cooling may help
Very cold temperatures may aggravate spasticity

Question 17

what happens to mobility in MS?

Answer 17

Impaired mobility can occur due to weakness, spasticity, cerebellar or sensory ataxia, visual, fatigue, or usually a combo of factors

Question 18

how can mobility tools be beneficial for MS?

Answer 18

Rollators with seats
Standard wheelchairs are a back-up
Power mobility should be considered

Question 19

how does bladder and bowel issues affect MS?

Answer 19

Mobility can have great effects in these areas

Constipation or UTI problems can aggravate spasticity

Question 20

what is the cycle of sxs of MS?

Answer 20

decrease in exercise
spasticity + constipation
bladder problems
decrease sleep
decrease cognitive fx
fatigue + depression

Question 21

how does depression affect MS?

Answer 21

effect all aspects of life especially compliance with tx

Question 22

how is cognitive fxing affected in MS?

Answer 22

Attention deficits
Deficits in info processing speed
Deficits in working memory
Deficits in executive control
Perceptual processing deficits
Deficits in memory fxing

Question 23

what do MS patients complain about cognitively?

Answer 23

I can’t remember things
I feel “foggy”, “cloudy”
I’m just “different” now

Question 24

why is the age of MS onset significant?

Answer 24

Age of onset -> career productivity
Career development -> slows or stops
Physical and cognitive impairments -> early retirement

Question 25

what are the biggest Obstacles to maintaining employment?

Answer 25

info processing deficits
memory deficits
Cognitive Fatigue

Question 26

how does early retirement occur?

Answer 26

Inability to keep up with work Reinforces depression and leads to leaving situation instead of adapting environment