Multiple sclerosis

Question 1

What is MS?

Answer 1

a chronic demyelinating disease of the CNS characterised by an inflammatory process and causing widespread degeneration of the CNS, gradually resulting in severe neurological deficit

Question 2

What 4 main thigs happen in MS?

Answer 2

disruption of blood-brain barrier
leakage of inflammatory cells
destruction of oligodendrocytes and myelin sheath
disruption of nerve signals, rate of conduction of nerves is slowed down

Question 3

What do oligodendrocytes do?

Answer 3

myelinate axons in the CNS

Question 4

name some suspected triggers of MS

Answer 4

environmental factors
-occurs more frequently in areas further from the equator
- low vitamin D levels
-smoking
obesity in childhood and adolescence particularly in girls
viral factors
Genetic factors
-200 genes identified that contribute to developing MS

Question 5

Is MS an inherited disease?

Answer 5

no

Question 6

At what age are people with MS generally diagnosed?

Answer 6

20-40 years of age

Question 7

Name 4 types of MS

Answer 7

Benign MS
Relapsing remitting MS
Secondary progressive MS
Primary progressive MS

Question 8

Name some of the most common signs and symptoms of MS

Answer 8

fatigue
difficulty walking
vision problems, such as blurred vision (often coming from optic neuritis)
problems controlling bladder
sensory deficits
increased muscle tone
reduced balance
ataxia
problems with thinking, learning and planning

Question 9

What area is potentially damaged if a patient with MS has vision deficits?

Answer 9

occipital lobe, optic nerve, thalamus

Question 10

What area is potentially damaged if a patient with MS has weakness?

Answer 10

motor cortex, descending pathways

Question 11

What area is potentially damaged if a patient with MS has spasticity and hyperreflexia?

Answer 11

motor cortex, descending pathways

Question 12

What area is potentially damaged if a patient with MS has ataxia and poor coordination?

Answer 12

cerebellum

Question 13

What area is potentially damaged if a patient with MS has sensory loss?

Answer 13

sensory cortex or ascending pathways

Question 14

What area is potentially damaged if a patient with MS has dizziness or poor balance?

Answer 14

vestibular system or cerebellum

Question 15

What area is potentially damaged if a patient with MS has sphincter disturbance?

Answer 15

spinal cord

Question 16

What area is potentially damaged if a patient with MS has sexual dysfunction?

Answer 16

spinal cord

Question 17

What area is potentially damaged if a patient with MS has mood problems?

Answer 17

limbic system, dopamine system, hypothalamus

Question 18

What area is potentially damaged if a patient with MS has decreased intellectual function?

Answer 18

frontal lobe

Question 19

What area is potentially damaged if a patient with MS has fatigue?

Answer 19

complex

Question 20

How long does a diagnosis for Ms take?

Answer 20

several months or more because no single test can conclusively diagnose

Question 21

What 6 events have to occur for somoene with Ms to have had a relapse?

Answer 21

clinical event of the type usually seen by MS
event must last at least 24 hours
objective findings must be present
the event is not a temporary worsening entirely due to fever or infection
to count as a distinct (new) attack, the onset of a clinical event must be at least 30 days after the onset pf any prior attack
a single paroxysmal episode does not constitute a relapse, but multiple paroxysmal events occurring over 24 hours or more can equal an attack

Question 22

What does treatment for a relapse of MS involve?

Answer 22

5-day course of steroid tablets taken at home
or
injection of steroid medicine given in hospital for 3-5 days

Question 23

What do steroids do?

Answer 23

reduce inflammation

Question 24

What are the main benefits for taking disease modifying drugs for MS?

Answer 24

fewer relapses
less severe relapses
reduce build up of disability which can occur if recovery isn’t complete form relapses

Question 25

Nam some anti-spasticity agents and relaxants

Answer 25

baclofen
tizanadine
canabis

Question 26

Name some medicines used for neuropathic pain

Answer 26

gabapentin
pregabalin
amitriptyline
carbamazepine

Question 27

Name some factors that are associated with a relatively better disease course

Answer 27

being female
being less than 40 years old when diagnoses
having fewer relapses in the first few years after diagnosis
making a complete recovery from relapses
having long intervals between relapses
having symptoms that are mainly sensory in nature

Question 28

Who will be involved if an MS patient has difficulty walking?

Answer 28

physio
OT

Question 29

Who will be involved if an MS patient has vision problems?

Answer 29

ophthalmologist
MS nurse
OT
Neurologist

Question 30

Who will be involved if an MS patient has bladder problems?

Answer 30

MS Nurse
Continence nurse

Question 31

Who will be involved if an MS patient has sensory deficits?

Answer 31

Physio
OT
MS Nurse
Neurologist

Question 32

Who will be involved if an MS patient has spasticity?

Answer 32

Physio
OT
Neurologist

Question 33

Who will be involved if an MS patient has balance problems?

Answer 33

Physio

Question 34

Who will be involved if an MS patient has ataxia?

Answer 34

Physio
OT

Question 35

Who will be involved if an MS patient has problems with thinking, learning and planning?

Answer 35

OT
Neuro Psych
MS nurse

Question 36

Who will be involved if an MS patient has sexual dysfunction?

Answer 36

MS Nurse

Question 37

Who will be involved if an MS patient has mood problems?

Answer 37

Neuro Psych
MS Nurse

Question 38

Who will be involved if an MS patient has swallowing difficulties?

Answer 38

speech and language therapist
Dietician