Flashcards in Module 11 Deck (33)
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What is multiple sclerosis?
A chronic inflammatory demyelinating disease of the CNS characterized by inflammatory plaques that destroy myelin throughout the CNS and is one of the most common neurological diseases affecting young adults.
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What does charcot's triad include?
Intention tremor- when reaching for something their hand shakes
Scanning speech- stop after every syllable
Nystagmus- jumping eyes
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What is the range of the age onset of MS?
15-50
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What is the genetic influence of MS?
Females 2:1
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Is MS Genetic or not?
Is genetic
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What is the prevalence rate of MS?
400,000
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What is the incidence rate of MS?
10,000
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Is MS fatal?
No
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What is the etiology of MS?
Unknown
Genetic susceptibility
Theory: viral-induced autoimmune disease (herpes viruses and chlamydial pneumonia, immune response triggering antigen activation, demyelination and gliosis)
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What is the geographical distribution of MS?
It occurs with higher frequency in temperate versus tropical climates. Latitudes closer to the equator tend to have lower frequency.
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What percent of MS Is relapsing/remitting MS (RRMS)
85%
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What does relapsing/remitting MS eventually turn into?
Secondary- progressive MS (SPMS)
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What percent of MS is primary-progressive MS (PPMS)?
10%
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What percent of MS is progressive-relapsing MS (PRMS)?
5%
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What is relapsing/remitting MS?
Relapses during which time new symptoms can appear and old symptoms resurface or worsen.
relapses followed by periods of remission, during which time full of partial recovery from deficits acquired during the relapse occurs.
relapses last days, weeks, or months and recovery can be slow or almost instantaneous.
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What is Secondary Progressive MS?
Gradual worsening of disease between relapses, and apart from some remission, following relapsing episodes, no real recovery.
after 10 years, 50% of people with RRMS develop SPMS and 90% by 25-30 years.
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What is Primary Progressive MS?
Gradual progression of disease from onset with no plateaus or remissions; however, some patients experience occasional plateaus and minor remissions. Onset typically after 40 years of age.
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What is Progressive Relapsing MS?
Progressive course from onset with marked relapses. some recovery may occur following relapse but is followed by gradual worsening of symptoms until the next relapse. Onset typically after 40 years of age.
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What are some exacerbating factors of MS?
Viral or bacterial infection, organ system disease, and Uthoffs symptom.
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What is Uthoffs symptom?
when the temperature rises patients get weaker. when the temperature cools down they get better.
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What are the diagnostic criteria for MS?
Evidence of two relapses
relapses separated by time/space
no other explanation for relapses
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What do interferon's do?
Block immune system, reduce inflammation and swelling
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What are the three main interferons of MS?
avonex: interferon beta-1a
betaseron: interferon beta-1b
rebif: interferon beta-1a
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What does copaxone: glatiramer acetate do?
Blocks T-cells: turns them off.
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What does novantrone: mitoxantrone do?
Immune suppressant
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What are the drugs used for symptomatic symptoms of MS?
acute relapses-prednisone
fatigue- amantadine
spasticity- Balofen
bladder dysfunction- Detrol
Tremor- klanopin
Dizziness- meclizine
pain- vicodin
depression-paxil
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what are some common impairments of MS?
Sensory change, pain, visual changes, weakness, fatigue, spasticity, imbalance, coordination impairments, gait impairments, speech impairments, swallowing impairments, cognitive impairments, depression, affective impairments, cardiovascular dysautonomia, bowel dysfunction, bladder dysfunction, sexual dysfunction.
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What are some visual impairments caused by MS?
oscillopsia
diplopia
nystagmus
scotoma
internuclear opthalmoplegia
marcus gunn pupil
optic neuritis
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What is oscillopsia?
Can't focus on one spot- vision stability
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What is diptopia?
Double vision
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What is scotoma?
Spot in vision no middle but have peripheral vision
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What is internuclear opthalmoplegia?
Very common; can't adduct eyes across midline. Gets stagmus because it's trying to pull the other eye.
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