Term
| A demyelinating dz of the CNS characterized by a course of recurring relapse and remissions, upon which are superimposed gradual neurologic deterioration. |
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Definition
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Term
| Charactized by numerous demyelinated lesions called plaques. Plaques can be scattered throughout the nervous system. The PNS is not affected. The distribution of plaques varies greatly from one person to another. |
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Definition
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Term
| Onset is usually between 20 and 50. It is twice as common in women than men. European descent is more likely to have this dz. Occurs most often in moderate temp regions of the world. |
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Definition
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Term
| What are the known facts about how MS is caused? |
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Definition
Unknown etiology
-Immune system is abnl with abnl lymphocyte function.
-Genetic link - increased incidence of MS among immediate relatives of pts with MS (increased risk with siblings and twins)
-Thought to be multi-genetic - many separate inherited genes which cause a greater susceptibility to MS |
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Term
| Disease in which the pt remains fully functional in all neurological systems 15 years after onset. <20% of cases. 1 episode but never have any more systems. |
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Definition
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Term
| Rare disease course with rapid onset and almost continual progression leading to significant disability or death within a short time after onset. No remission. Exacerbations only |
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Definition
| Malignant MS (Marburg Dz) |
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Term
| The most common course of MS. Affects approx 70% of cases. Characterized by clearly defined dz relapses (periods of acute worsening of neurological function) followed by remissions (periods without disease progression and partial or complete abatement of S&S. Relapses can last weeks. Remission may be years. Recovery will decrease with age or dz progression |
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Definition
| Relapsing/Remitting (RRMS) |
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Term
| About 80% of RRMS cases will develop into this later. |
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Definition
| SPMS (Secondary Progressive MS) |
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Term
| This begins with a relapsing/remitting course followed by progression with or without occasional relapses, minor remissions or plateaus. Recovery is not as good and relapses are more often. |
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Definition
| Secondary Progressive MS (SPMS) |
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Term
| This begins with a progressive dz course from the beginning with clear, acute relapses that may or may not resolve to full recovery. The intervals between relapses show continued dz progression. |
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Definition
| Progressive-Relapsing MS (PRMS) |
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Term
| This is the rarest form of MS. It occurs in about 10% of cases. Progressive dz without plateaus or remissions or with occasional plateaus and temporary or minor improvements |
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Definition
| Primary Progressive MS (PPMS) |
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Term
| Name 3 events that are highly suggestive of MS |
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Definition
-Gait disturbances
-Visual disturbances such as double vision
-Peristent UTIs |
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Term
| There are several factors that can predict favorable outcomes. Name 4 |
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Definition
1. Female
2. Onset before age 35
3. Monoregional vs polyregional
4. Complete recovery after attack |
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Term
| Eyes affected instead of the whole body |
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Definition
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Term
| Name 4 less favorable outcomes for MS |
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Definition
1. Male
2. Brain stem symptoms (nystagmus, tremors, ataxia)
3. Poor recovery after exacerbations
4. Increased frequency of attacks |
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Term
| Name 3 Psychosocial considerations for MS |
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Definition
1. Ambiguity of Dx (not knowing what type, severity, or recovery)
2. Unpredictability of course
3. Covert symptoms (person may not look like they have MS or may hide from employer) |
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Term
| Name some classic symptoms of MS |
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Definition
-Fatigue -Spasticity
-Motor Weakness -Dysarthria
-Ataxia -Intension Tremors
-Impaired vision (diplopia, nystagmus)
-Impaired sensation (tingling, band-like sensation, pins and needles, numbness of face, body, or extremeties, position sense and vibratory sense in LEs)
-Impairment of deep sensation (be aware of pressure sores)
-Bladder dysfunction
-Alteration in emotional responses (depression, dementia)
-Increased DTR's
-Intolerance to heat
-Sexual dysfunction
-Pain
-Short term memory issue |
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Term
| Name some causes for temporary deterioration (not an exacerbation) |
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Definition
| Heat, dehydration, sleep deprivation, organ disorders (liver, kidney), pregnancy, trauma, infection, stress, etc |
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Term
| Name 4 common measurement tools done on pts with MS |
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Definition
1. FIMS
2. Kurtzke Scale - standardized for MS
3. MSQLI - MS QOL inventory (used in research for MS, used by clinicians to determine pts goals and current status)
4. MFIS - Modified Fatigue Impact Scale |
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Term
| Name 11 parts to strengthening program |
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Definition
1. Unaffected ms (strengthen to max if ms is grade 4 or better)
2. Adaptive devices (w/c, crutches)
3. Balance must be made between rest and exercise
4. Slow strengthening program progression (Ex: 5-10 reps of ex - increase to 1-2 reps every 2-3 weeks up to 20-25 reps per exercise. If wts are added, decrease to 5-10 reps with the above progression)
5. Ex in cool atmosphere (heat intolerant)
6. Stretching before strengthening
7. Ex should be performed at submax resistance with frequent reps
8. Emphasis should be placed on proximal ms
9. Combine strengthening with aerobic, balance, and/or spasticity-reducing exercise
10. Avoid excessive fatigue - frequent rest throughout
11. Body weight support initially |
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Term
| Name 5 things to asses in MS patients |
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Definition
1. Strength (don't fatigue; do gross motor groups)
2. ROM
3. Sensation (deep, do sensory test)
4. Balance
5. Posture control |
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