Multiple Sclerosis Flashcards
Define MS?
It is a chronic demyelinating disease of the CNS characterised by an inflammatory process which causes widespread degeneration of the CNS.
What are the suspected triggers of MS?
Infection Vaccination Trauma/Whip lash, Emotional stress, Genetics, Vitamin D,
How does MS occur?
A trigger causes disruption to the blood-brain barrier, which causes leakage of inflammatory cells. These inflammatory cells causes destruction of oligodendrocytes and myelin sheath. This leads to disruption in nerve signals and a slower rate of conduction. This then allows plaques to form throughout the CNS. (The plaques can be detected on a MRI scan which is how it’s normally confirmed).
What are the 4 types of MS?
Silent/benign: only have one or two episodes and then it becomes silent.
Relapsing-remitting: periods where you have a decrease in disability (slight regain in function), followed by a relapse when the condition gets worse again.
Secondary chronic progressive: similar to relapsing -emitting however each relapse leads to a much greater disability.
Primary progressive: no relapses just gradually progressing overtime.
What are the signs and symptoms in each area of the brain?
demyelination in the:
Occipital lobe, optic nerve and thalamus=
Visual problems such as double vision(diplopia) and acuity.
Motor cortex, descending pathways=
Weakness, spasticity and hyperreflexia
Cerebellum= ataxia and poor coordination
Sensory cortex, and ascending pathways=
Sensory loss eg parasthesia, tingling and burning
Vestibular system or cerebellum=
Dizziness and poor balance
Spinal cord= sphincter disturbance and sexual dysfunction
Limbic system, dopamine system and hypothalamus= psychiatric and psychological disturbances.
Frontal lobe= decreased intellectual function
What are the initial symptoms?
Limb weakness, Optic neuritis, Parasthaesia, Diplopia, Vertigo, Micturationroblems.p
How can they diagnose MS?
Looking at clinical history,
MRI scans,
Nerve conduction tests,
Lumbar puncture to test for oligoclonal bands.
How can we identify relapses?
We must be able to see some of the Symptoms/changes that last more than 24 hours,
And must be clear that it’s not a result of an infection that will clear.
In order to count as a new attack how much longer does a relapse need to be after the previous remission (stable period)?
30 days
What medication can be given to help treat MS relapses?
IV methyl prednisolone, Oral methy predisolone with ranitidine, Interferons, Natalizumab, Glatramer acetate,
What outcome measures can be used to Record people’s levels of ability?
Stage and severity of the disease-
Expanded disability status scale
Function and participation- MSIS 29 (looks at Ms in daily life)
Impact on walking-
MSWS12
Balance and functional reach test
Get up and go test
