Multiple Sclerosis (MS) Flashcards
What is multiple sclerosis (MS)?
A progressive long-term neurological disorder of theCNS where the myelin sheath is damaged due to an autoimmune response
- reduce or lose nerve conduction
What is the most common cause of nontraumatic neurological disability?
Multiple Sclerosis (MS)
What are some symptoms of multiple sclerosis (MS)?
- Blurred vision/vision problems
- Weakness
- Numbness + tingling
- Walking difficulty
- Fatigue
- Dizziness
- Muscle spasms
- Cognitive dysfunction
- Pain
- Depression
- Bladder + bowel dysfunction
What are some factors which can contribute to Multiple Sclerosis (MS)?
Environmental:
- Viral agents (Epstein-Barr)
- Smoking/obesity/diet
- Sunlight exposure/Vitamin D
Genetic:
- Multiple gene involvement demonstrated
What are the different classifications of Multiple Sclerosis (MS)?
- Relapse Remitting
- Primary Progressive
- Secondary Progressive
Describe relapse remitting Multiple Sclerosis (MS)?
- Around 90% of patients initially have this, most of them ultimately developing secondary progression.
- Periods of significantly worse symptoms followed by periods of near complete symptom resolution
Describe secondary progressive Multiple Sclerosis (MS)?
- 65% of those with relapse remitting enter secondary progressive
- Symptoms can fluctuate but continual slow progression of symptoms
Describe primary progressive Multiple Sclerosis (MS)?
- Around 10% of patients have it (currently no disease-modifying treatment)
- Progression from outset
How can Multiple Sclerosis (MS) be diagnosed?
- Neurological signs & symptoms (multiple episodes, separate in time and location within the CNS)
- MRI (contrast methods reveal active + burnt-out plaques, and location - but should not be used alone)
- Evidence of CNS lesions in space and time
- Cerebrospinalfluid via a lumbar puncture reviewed for the presence of inflammation (oligoclonal bands- immunoglobulins)
What is a pharmacological treatment for multiple sclerosis (MS) relapses?
Corticosteroids (oral, intravenous)
- hasten recovery from relapses but do not modify underlying disease
Explain whether disease-modifying therapies (DMT’s) able to help patients with multiple sclerosis (MS)?
- Don’t ‘cure’ but can slow down disease progression
- Frequency in relapses and MRI outcomes- lesion number andvolume
- Not always available with progressive subtypes
- Haematopoietic stem cell transplantation (HSCT)
- Cannabis (Sativex)
(Around 20 drugs available in the UK)
What symptoms of multiple sclerosis (MS) that can be treated with pharmacological treatment?
- Spasticity
- Pain
- Fatigue
- Anxiety and/or Depression
What is a recommendation for people with Multiple Sclerosis (MS) to manage their condition?
Regular exercise
- Progressive resistance training
- Aerobic exercise
- Balance exercises (yoga, Pilates)
Cognitive Behavioural Therapy (CBT)
Assess for factors that may worsen spasticity (e.g.: pressure ulcers, bladder + bowel dysfunction and infections, poor posture, pain)
What objective assessment things need to be considered with patients with Multiple Sclerosis (MS)?
- Tremor
- Spasm/stiffness
- Cognition
- Balance- perturbation,reactions
- Gait
- Fatigue
- Mood
- Pain
- Function (could be from wheelchair bound to marathon running depending on the stage of the disease).
What treatments may we provide as physios for patients with Multiple Sclerosis (MS)?
- Stretching/positioning
- Strengthening
- Aerobictraining
- Upper Limb (gaming, dexterity,task specific practice, VR, CIMT)
- Painmanagement
- Spasticity/spasm management
- Aids equipment andorthoses
- Functional Electrical Stimulation (FES or E-stim)
- Balance re-education, fallsstrategies
- Fatigue management
- Respiratory review
- Mood and cognitive deficits will need addressing
- Health promotion, self management
- Sign posting/advice
