Multiple Sclerosis (GOLD) Flashcards
(22 cards)
What is MS?
Demyelination of the myelin sheaths in the brain and the spinal cord, leading to a decrease in efficiency of nerve impulses
- subsequent plaque formation and eventual failure of nerve impulses
Etiology
Unknown
Possibly epstien-barr virus
Signs and Symptoms
- visual problems (diplopia)
- sensory changes
- weakness
- ataxia
- balance dysfunction
- fatigue
Treatments
Pharmacology
- Goal is to lessen the length of exacerbations and maximize patients health
Which age range has the highest incidence rates?
- highest incidence between 20-35 y/o
Which gender is more affected?
2x as common in Women
What climate is associated with a higher incidence of MS?
Temperate Climates
What ethnicity is most likely to have MS?
Caucasians
What is the most common classification of MS?
Relapsing-Remitting (85% of cases)
What laboratory or imaging studies would confirm the diagnosis early in the disease?
There is not a single testing procedure to diagnose MS early in the disease.
[MRI inconclusive]
What guidelines must be followed for a clinical diagnosis of MS to be made?
An individual experiences two separate attacks and shows evidence of two separate lesions.
Reliable patient history of symptoms are vital in the diagnosis of MS
What happens as the disease advances?
Exacerbations leave greater ongoing disability, length of remisions decrease
What PT interventions are indicated with MS
- Regulation of activity level*
- relaxation and conservation energy techniques
- Normalization of tone*
- adaptive/assistive device training
[These are VITAL to quality of life]
What part of the day should exercise be adminstered?
Morning patient is rested; to avoid fatigue
What factors can influence exacerbations?
- HEAT
- Stress
- Infection
- Trauma
- Pregnancy
What do overall mortality rate and long-term outcomes correlate with?
- age of diagnosis
- number of attacks and exacerbations
- frequency and duration of remissions
- type of MS
Those with MS mostly die from?
Secondary Complications [Think things due to a sedentary life style]
- disuse atrophy
- pressures sores
- contractures
- pathological fractures
- renal infection
- pneumonia
What additional findings are likely with MS?
- Emotional Lability*
- Depression*
- Spasticity
- Tremor
- paralysis
- sexual dysfunction
- Bowel and Bladder Incontinence
What is Relapsing Remitting (RRMS)
-
Clearly Defined episodes of new or worsening symptoms
Hallmark Sign: Period of remission between attacks
Primary Progressive (PPMS)
- Slow accumulation of disability without relapses
- No clear periods of remission
Secondary Progressive (SPMS)
- Initially follows course of relapsing remitting
- Remissions become less apparent and disease worsens steadily over time
Progressive Relapsing (PRMS)
Steadily worsening of disease from beginning, but with clear attacks
- Does not experience clear remissions
