Multiple sclerosis Flashcards
what does it affect/type of disease?
What is MS?
- autoimmune disease that affects the CNS- brain & spinal cord.
where do you find it, what does it protect, what is its function?
what is myelin?
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- In the central nervous system, a substance called myelin protects the nerves, a bit like electrical insulation round a wire.
- Myelin helps messages travel quickly and smoothly to control the whole body.
5 points
pathophysiology of MS
- the immune system mistakenly attacks the myelin.
- damages it, leaving lesions or plaques.
- damage disrupts messages travelling along the nerve fibres.
- messages can slow down, become distorted, or not get through at all.
- can sometimes cause damage to the nerve fibres, causes the increase in disability that can occur over time.
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risk factors
- It is more common in countries furthest away from the equator -low in vit d
- Genetics
- infection
- being overweight
- 3x more common in women
- Smoking can make MS speed up disability- can cause more and bigger lesions and more relapses & cause disease modifying therapies to work less
3 types of ms
- relapsing remitted
- secondary progressive
- primary progressive
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symptoms
- Altered mood
- Bladder and bowel problems
- Fatigue - primary fatigue caused by damage to brain and spinal cord, secondary fatigue from living with ms symptoms like pain
- Impaired balance
- Memory and thinking - take longer to answer, struggle to find words, have short term memory deficits and problems in concentrating
- Muscle stiffness and spasms- Tightening and rigidity of muscles, also known as spasticity. This can lead to difficulties with positioning and moving. People can also have uncontrolled jerking of limbs or their whole body.
- Pain and unpleasant sensations -stiffness or spasms in muscles, nerve pain. Or symptoms affecting the senses like numbness or pins and needles, or a tightness in the chest known as the ‘MS hug’.
- Sexual problems
- Speech difficulties
- Swallowing
- Tremor
- Visual problems
percentage of people with rr
85%
what is a relapse definitoin?
recovery?
do you see symptoms?
cause?
what is relapsing remitting ms?
- A relapse is defined by the appearance of new symptoms or the return of old symptoms for a period of time longer than 24hours without having a change of core body temp or infection
- Relapses can be mild or severe
- Recovery from relapses can be good, however half of relapses may leave some problems
- Disability doesn’t get worse gradually but the effects of a relapse can remain
- Damage can be happening even if there are no signs that may be noticeable
- No definitive cause of relapses, but infection and stress can make it more likely
4, diagnosis criteria name?
tests for ms
Diagnosis criteria - McDonald criteria
1. Neurological exam, history, health problems and symptoms now and in the past. Physical exam checking movements, reflexes and senses, such as eyesight
2. MRI scans - to view lesions
3. Evoked potential tests - measures how fast messages travel between the brain and eyes, ears and skin. If MS has damaged the myelin around the nerves around the nerves that control these parts of the body reactions will be slower
4. Lumbar puncture - needle inserted in space around the spinal cord. cerebrospinal fluid is taken out and checked for signs that the immune system has been active in the brain and spinal cord (which does not happen if person does not have MS). These signs, which can include ‘antibodies’, show that a person is very likely to have MS.
2 how to diagnose after how long
secondary progressive
- After having relapsing remitting MS many people develop secondary progressive
- Hard to diagnose- a person must’ve had relapses in the past, but now levels of impairment have been getting steadily worse for at least 6 months
primary progressive
- Symptoms are progressive from the start and gradually get worse over time, rather than appearing as sudden relapses
- Early symptoms are subtle problems with walking which develop slowly over time
what%, age, gender
who is affected by primary progressive
- effects 10-15% of people diagnosed with MS
- Typically diagnosed in 40+
- Equal men and women diagnosis
disease modifying therapys
Slow down progression of MS and reduce the frequency and seriousness of relapses
