NM Multiple Sclerosis Flashcards
Chronic, degenerative, _________ disease of CNS
Demyelinating
Etiology is unknown but likely _____, _________
Viral, autoimmune
Demyelinating lesions (________) impair neural transmissions, so nerves ______ ______
Plaque
Fatigue fast
Where are the lesions common?
Pyramidal tract
Dorsal columns
Periventricular areas of cerebrum
Cerebellar peduncles
Precipitating/exacerbating factors include what 4 things?
Infection
Trauma
Pregnancy
Stress
Transient worsening symptoms = Adverse reaction to \_\_\_\_\_ \_\_\_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_\_
Heat
Dehydration
Hyperventilation
Fatigue
What is the most common type?
RRMS
What is relapsing remitting MS? (RRMS)
Discrete attacks of relapses with either full or partial remissions in subsequent weeks/months
What is primary progressive MS? (PPMS)
Disease progression and deterioration in function from onset
Modest fluctuation in Neuro disability
NO DISCRETE ATTACKS
What is secondary progressive MS (SPMS)?
Starts off as RRMS but then changes to PPMS, with or without continued acute attacks
What is progressive relapsing MS (PRMS)?
Steady deterioration with acute attacks occasionally
What is clinically isolated syndrome?
1st episode of inflammatory demyelination in the CNS that could become MS if more activity occurs
Can progress to RRMS
What Dx tests would you do?
LP/CSF — would show increased gamma globulin
CT/MRI
Myelogram
EEG
Exam includes:
1) History
2) Cog/affective status — what are you looking for?
Mild-mod cog impairment common; euphoria, emotional dysregulation
Exam includes:
3) Communication — what are you looking for?
Dysarthria
Scanning speech
Dysphasia
Exam includes:
4) ROM/deformity: associated with ____
Disuse
Exam includes:
5) sensation: what are you looking for?
Parasthesias Hyperpathia Dysesthesia Trigeminal neuralgia Lhermitte’s sign
Exam includes:
6) Vision: what may you see?
Diplopia Blurred vision Optic neuritis Scotoma (blind spot) Nystagmus
Exam includes:
7) skin integrity
8) Muscle tone, DTRs: what would you see?
Spasticity
Hyperreflexia
Exam includes:
9) muscle strength/control: ______
Paresis
Exam includes:
10) coordination: you may see what?
11) balance: ______ involvement
Ataxia
Intention tremor
Dysmetria
Dysdiadochokinesia
Vestibular
Exam includes:
12) gait may be _________
Ataxia
Exam includes:
_______ is the number one complaint as the day progresses
Fatigue
What classes of drugs are used?
Immunosuppressant drugs
Interferon drugs
Sx management of spasticity
Sx management of urinary problems
What are the immunosuppressant drugs that are used?
ACTH
Steroids (-sone)
What are the interferon drugs that are used?
Avonex
Betaseron
Copaxone
What spasticity drugs are used?
Baclofen, diazepam (Valium), dantrolene
Baclofen pump
Phenol block surgery
What urinary drugs are used?
Anticholinergics
What two things should you watch out for in your pts with MS?
UTI and respiratory infection
What intervention can you use with diplopia?
Eye patching
_______ ______ techniques are important for this population
Energy conservation
Avoid precipitation exacerbations:
Use _________ practice schedule
Rest intervals should be carefully ___________
____ time > _____ time
Exercise should increase in _____ before _______
DISTRIBUTED
Spaced
Rest time > exercise time
Duration before intensity
