Patho Of MS Flashcards
Immune-mediated inflammatory disease of the CNS
Multiple Sclerosis
Activate peripheral t-cells breach____ and release chemicals to rally
Blood brain barrier
Immune system forces
MS ____x higher for person with affected relative
F:M ratio
10-50 x
3 women-1 men
Approximately 55-75% of pts have _____ at some point duringg course of disease
Spinal cord lesion
Optic nerve involvement and myelopathy
Neuromyelitis optica
Different MS classifications
Relapsing remitting MS
Secondary progressive MS
Primary progressive MS
Malignant MS
Accute attacks with full recovery
How many ppl Dx with this form initially?
Relapsing remitting MS (RRMS)
85%
Starts with RRMS followed by progression at variable rate with relapses and plateus
Secondary Progressive MS (SPMS)
50% of ppl with RRMS get it
Progression of disability from on w/ or w/o plateau, remission, improvement
Who has worst prognosis
Primary progressive MS (PPMS)
Progression from onset but clear acute relapses
Progressive Relapsing MS (PRMS)
Rare and results in death
Malignant MS
Symptoms lasting for more than 1-2 days
Relapse
What causes the axonal damage in MS
Inflammation
Dx of MS is based on
Med history
Signs + Symptoms
Lesions of MS are ____ and involve
Deep in brain and involve white matter (plaque)
MS lesions grouped into
4 patterns
Quantifies disability in 8 Functional Systems
Expanded Disability Status Scale (EDSS)
EDDS of 1-4.5 refer to MS that is ___
5-9.5 is
Fully ambulatory
Impaired ambulation
Symptoms of MS
Fatigue Pain Impaired ambulation bowel/bladder Motor impairments (just a summarization)
Factors of favorable prognosis
Female <35 y/o Monoregional Sensory vs motor Recovery after exacerbation
Less favorable Prognosis of MS
Male >35 Cerebellar symptoms Decreased recovery African-American
2 aspects of medication Tx for MS
Immunomodulatory Therapy
Symptom Modifying
Disuse process that occurs slowly and unnoticed..
Decreased by exercise
Creeping diability
Pts with MS have __ less aerobic capacity
30%
PT focus for MS is to
Improve and maintain Function
Most common symptom of MS
Fatigue
Fatigue caused by factors related to the disease
Primary fatigue
Fatigue caused by pathological consequences of diseaase
Secondary Fatigue
Subjective fatigue with mental fatigue/ axon damage/Reduced glucometabolism
Disorder of central, peripheral, and autonomic NS
Central Fatigue
Disorder of muscle and neurmuscular junction
Disuse
Impaired calcium
Impaired excitation
Peripheral fatigue
Central and peripheral fatigue can
Coexist
Disease modifying drugs used for:
Exercise used for:
Central fatigue
Peripheral Fatigue
Fatigue in MS patients may be reduced by increasing:
Oxidative Capacity of Skeletal muscle
Treatment for one problem can
Aggravate another
Encourage balance and endurance training before someone has begun to experience falls
Over-rehab
Body core tempt lowest in
Morning
Best modality for MS
Air dyne
When is fatigue symptom from exercise normalized
30 minutes
Reduction of visual activity and increased fatigue associate with hyperthermia
Uhthoff’s Phenomenon
Fracture risk of pts with MS compared to norm
2-3.4x
