Multiple Sclerosis

Question 1

Define multiple sclerosis

Answer 1

A chronic autoimmune disease of the CNS, characterised by an inflammatory and demyelination/degeneration of the CNS. Gradually resulting in severe neurological deficit. Caused by a genetic predisposition and environmental factors.

Question 2

Types of MS

Answer 2

Relapsing-remitting, unpredictable relapses followed by periods of months/years of remission.

Primary-progressive, no remission after initial symptoms, progressive of disability from onset.

Secondary-progressive, progressive neurological decline between acute attacks without any definite periods of remission.

Progressive-relapsing, have a steady neurological decline but also have superimposed attacks.

Question 3

Pathology of MS

Answer 3

There’s a disruption of blood-brain barrier, allowing T-cells (lymphocytes) to enter CNS. T-cells attack the oligodendrocytes, responsible for maintaining myelin the sheath, and myelin causing scarring (sclerosis) of the axaon. Causeing inflammation which can also reduce transmission of information between neurones Demylinated axons can no longer effectively conduct electrical signals. Axons try to re-myelinate themselves which cause scar like plaques.

Question 4

Signs and symptoms of MS

Answer 4

1. Visual loss
2. Fatigue
3. Weakness
4. Spasticity/hypereflexia - plaques in spinal cord
5. Ataxia - plaques in cerebellum
6. Sensory loss
7. Dizziness/poor balance
8. Sphincter disturbance
9. Sexual dysfunction
10. Psychiatric problems - plaques in frontal lobe of cerebral cortex

Question 5

Risk factors of MS

Answer 5

1. Gender F>M 2:1
2. Age
3. Family history
4. Race
5. Climate

Question 6

Physio treatment for MS

Answer 6

AROM exercises to keep muscles strong and flexible for ADL’s

Balance training - reduce falls

Gait re-education muscle stretching reduce pain and stiffness