Multiple Sclerosis

Question 1

Who is MS commonly seen in?

Answer 1

Is more common in women than men

Question 2

What causes MS?

Answer 2

Unknown - Could be genetic of environmental factors

Question 3

What is MS?

Answer 3

MS is an inflammatory, demyelinating disease of the CNS.

Question 4

What are some sign and symptoms of MS?

Answer 4

Unilateral optic neuritis, numbness/tingling in limbs; leg weakness; nystagmus

Question 5

What could we find in clinic in a patient?

Answer 5

Dysaesthesia;loss of vibration sense; trigeminal neuralgia; ataxia; tremor; spastic weakness; myelitis.

Question 6

Two signs characteristic of MS:

Answer 6

• Uhthoff’s phenomenon
Exacerbation of symptoms due to higher than usual ambient temperatures
Blurred vision during exercise
• Lhermitte’s sign
An electrical sensation that runs down the back when bending the neck

Question 7

Two main classifications of MS:

Answer 7

1. relapsing remitting (80% start this way)
   (long periods of remission between acute bouts, may have very slow progression)
2. a. primary progressive (steady progression - no acute bouts)
   b. secondary progressive (acute bouts followed by steady progression)

Question 8

Pathophysiology of MS

Answer 8

T cells attack myelin, cause an increase in cytokines which damage the oligodendrocytes in the CNS - Patchy inflammatory destruction (scleroses)

Question 9

Benefits of exercise in MS:

Answer 9

Improves strength
Reduces blood pressure
• Restore balance in production of pro-inflammatory cytokines and
anti-inflammatory cytokines
• Stimulate neurotrophic factors (NGF, BDNF)
• Help with associated disabilities – depression, fatigue

Question 10

Responses to exercise in MS:

Answer 10

Acute
• Overwhelming fatigue!
Chronic 
• Strength and endurance improves
• Cytokine balance
• Nerve growth factors

Question 11

Main problems in MS:

Answer 11

• balance, fatigue, spasticity, foot-drop

- May need to use cycle ergometer, toe clips