NP: Chapter 23 Multiple Sclerosis Flashcards
multiple sclerosis wat voor ziekte
chronic, of central nervous system -> multifocal inflammation and demyelination
onset of ms
between 20-40 years
prevalence of ms
most common neurological disorder in young adults
ms also occurs in children
oke
waar is de meeste inflammation
in white matter van: optic nerve, spinal cord, cerebellum and brain stem
ms often starts with..
impairment of sensory perceptions in the limb, or temporary problems with vision
what does inflammation of the brainstem cause
diplopia (dat je 2 beelden van ogen niet meer goed geintegreerd worden) en eye movement disorders
what are other symptoms of ms
decreased strength, coordination of limbs, functional disorders, sexual dysfunction, spasticity, pain, fatigue.
Unthoffs syndrome
MS patienten die meer last hebben van symptomen in hot climates
met welke questionnaire meet je neurological limitations
expanded disability status scale EDSS
edss model bekijken
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relapse-remitting MS
periods of recurrence alternating with periods of remission in which the patient is free of symptoms.
relapse =
inflammatory reaction in myelin sheet -> symptoms
which is the most common subtype of ms
RRMS
which subtypes of ms are there
relapse remitting ms
secondary progressive ms
primary progressive ms
wanneer is RRMS een active disease
eerst niet, want de relapses occur once or twice per year on average. but recovery from these exerbations may be incomplete, which in turn may cause impairments
secondary progressive ms
spms
after several years, 2/3 of rrms patients -> patterns of progressive deterioration with or without exacerbations and minimal remission.
primary progressive ms
constant progression of symptoms from the onset of the disease
hoeveel mensen hebben primary progressive ms
10-20% van de pt
kijken naar figuur van ms subtypes
oke
ms and life expectancy
life expectancy not severely affected by ms, most ppl die of other causes.
what is needed for a diagnosis of MS
- at least two periods with clinical symptoms
- symptoms can be accounted for by various white matter lesions in CNS (dus ook 2 verschillende symptomen)
soms ook MRI scan voor lesions if MS is suspected
wat voor csf differences hebben mensen met ms
increase lymphocytes and plasma cells, immunoglobulin g levels.
evoked potential test
bij ms, performed to assess the conduction along bv de optic nerve pathway
waar komt ms vaak voor
in temperate and cold zones
ms gender
women more than men
treatment of ms
high dose of corticosteroids -> kan maar even, voor temporary relief.
nu drugs die het nog meer terughouden, maar nog niks gevonden dat het echt cured.
cause of ms
autoimmune, by exogenous trigger in ppl with specific genetic predispositions. maar exact cause is unknown
hoeveel patienten met ms hebben cognitive impairments
40-70%
paced auditory addition test
for information processing speed, ms performes slowly
welk deel van memory is impaired bij ms
vooral retrieval, recognition is nog goed
sterke relatie tussen severity of cognitive impairments and the severity of ms
oke
what is the best predictor for cognitive functioning
cortical atrophy (not white matter lesions!)
bv the width of the third ventricle is een goede voorspeller voor cognitive impairments
oke
welke comorbidities bij ms
anxiety, bipolar and psychotic disorders
and depression a lot (30-50%)
15% of deaths bij ms are suicide
wat is de most limiting symptom
fatigue
