Multiple Sclerosis

Question 1

Ataxia

Answer 1

loss of voluntary muscle coordination

Question 2

Dyskinesia

Answer 2

is a term that refers to abnormal involuntary muscle movements and diminished voluntary movements.
i.e. a slight tremor of the hands; an uncontrollable movement of the upper body or lower extremities.

Question 3

MS symptom:

Ataxia or Dyskinesia

Answer 3

Ataxia: loss of voluntary muscle coordination

i.e. people think the person is drunk

Question 4

Myelin is produced by

Answer 4

oligodendrocytes

Question 5

Fatigue experienced in MS may be unrelated to exercise or exertion. T or F?

Answer 5

True (from MS quize)

Question 6

Strategies that can assist your patient to manage their fatigue include …

Answer 6

-Avoid exercising in warm environments
-Advise patient of increased fatigue as the day progresses
-Alternate short periods of exercise with periods of rest.
(from MS quize)

Question 7

Definition: Multiple sclerosis

Answer 7

an immune-mediated progressive inflammatory disease which causes the person’s own immune system to attack the myelin sheath around axons of the CNS.

Question 8

Pathophysiology: MS

Answer 8

Approximately 85% of ppl with MS begins with Relapsing-Remitting course. The remitting can be explained by the remyelination; however, because of the loss of oligodendrocytes, body cannot rebuild the destroyed myelin sheath completly, and when lesions occur in the CNS, it leads to infiltration of the leukocytes causing further breakdown of the myelin sheath, which over time may lead to Secondary-Progressive course.

Question 9

Clinical feature: MS

Answer 9

• Fatigue (most common; unrelated to exercise)
• Vision (blurred, double, Nystagmus)
• Muscle (weakenss, hypertonia, tremor, ataxia, imbalance)
• Numbness, tingling, pain
• Bladder & Bowel control (incontinence)
• Dysarthria, Dysphagia, Depression

Question 10

Lesion location: MS

Answer 10

• Optic nerve (blurred, double, nystagmus, loss)
• Brain stem (tracts, cranial nerves, cardiovascular system & respiratory control)
• Basal ganglia (dyskinesia, bradykinesia, LTM: Procedural learning)
• Cerebellum (ataxia, LTM: Procedural learning, nystagmus)
• Spinal cord (Sensation, weakness, bladder contro)

Question 11

Medical management: MS

Answer 11

• Beta interferons (help fight viral infection and regulate immune system)
• Corticosteroids- (immunosuppressive) reduce the inflammation

Question 12

Diagnosis: MS

Answer 12

In most cases, Px’s medical history and neurological exam provide enough evidence to meet the diagnostic criteria; however, MRI, Visual Evoked Potential are used to confirm the diagnosis or provide additional evidence.

Question 13

Most commonly seen in ______ between ___and ___ and occurs _ in 1000 in NZ. Less common in _____ and ______.

Answer 13

women, 20 - 40, 1, Maori and Pacific Islanders

Question 14

The cause is _______, however risk factors include age, gender, ethnicity, _______, ________, ________and ________

Answer 14

Idiopathic, genetic, environment, smoking, vitamin D (inadequate sunlight exposure)