Multiple Sclerosis, Parkinsons Flashcards
(23 cards)
What is Multiple Sclerosis (MS)?
A chronic demyelinating disease of the CNS characterized by an inflammatory process and causing widespread degeneration of the CNS, gradually resulting in severe neurological deficit.
What are the key components of the pathophysiology of MS?
- Disruption of blood-brain barrier
- Leakage of inflammatory cells
- Destruction of oligodendrocytes and myelin sheath
- Disruption of nerve signals
- Formation of plaques throughout the CNS
- Sclerosis means scarring in multiple sites.
What are potential causes of MS?
- Environmental factors
- Viral factors
- Genetic factors
What are the most common symptoms of MS?
- Fatigue
- Difficulty walking
- Vision problems
- Problems controlling the bladder
- Sensory deficits
- Increased muscle tone
- Reduced balance
- Ataxia
- Problems with thinking, learning, and planning
What is required for the diagnosis of MS?
Clinical history, neurological examination, MRI scan, evoked potential tests, lumbar puncture, and blood tests.
What criteria must be met for an MS relapse according to the McDonald Committee?
- Clinical event of the type usually seen in MS
- Event must last at least 24 hours
- Objective findings must be present
- Not due to fever or infection
- At least 30 days after prior attack
- A single paroxysmal episode does not count as a relapse.
What is the typical medical treatment for a relapse of MS?
- 5-day course of steroid tablets at home
- Injections of steroid medicine in hospital for 3 to 5 days.
What are the main benefits of Disease Modifying Drugs (DMDs) for MS?
- Fewer relapses
- Less severe relapses
- Reduced build-up of disability.
What types of treatments are available for MS symptoms?
- Anti-spasticity agents (baclofen, tizanidine, cannabis)
- Neuropathic pain medications (Gabapentin, Pregabalin, Amitryptyline, Carbamazepine)
- Anti-depressants
- Analgesia
- Catheterisation
- PEG feeding
- Hyperbaric oxygen.
What factors are associated with a relatively better disease course in MS?
- Being female
- Being less than 40 years old at diagnosis
- Having few relapses in the first few years
- Making a complete recovery from relapses
- Long intervals between relapses
- Mainly sensory symptoms.
How many people in the UK are living with Parkinson’s Disease?
Approximately 145,000 people.
What are the cardinal signs of Parkinson’s Disease?
- Bradykinesia
- Rigidity
- Resting tremor
- Postural instability.
What are secondary clinical symptoms of Parkinson’s Disease?
- Difficulty initiating and terminating movement
- Fatigue
- Freezing
- Festinating gait pattern
- Sleep disorders
- Swallow dysfunction
- Anxiety and depression.
What is the function of the basal ganglia?
- Well-learned motor skills and movement sequences
- Preparation and planning
- Initiation and termination of movement
- Sequencing and timing
- Regulating muscle tone.
What pathways exist within the basal ganglia?
- Direct pathway (promotes movement)
- Indirect pathway (inhibits movement).
What role does dopamine play in the basal ganglia pathways?
- Excites the direct pathway (promotes movement)
- Inhibits the indirect pathway (inhibits movement).
What are the types of medications for Parkinson’s Disease?
- Dopamine Replacements (e.g., Madopar, Sinemet)
- Dopamine Copycats (e.g., Apomorphine, Pergolid)
- Dopamine Protectors (e.g., MAO-B inhibitors, COMT-inhibitors).
What are secondary effects of Parkinson’s Disease medication?
Varied and wide-ranging, including dyskinesia.
What characterizes postural instability in Parkinson’s Disease?
Characteristic flexed posture, flexed hips and knees, inability to access balance reactions.
What is the Modified Hoehn and Yahr scale used for?
Clinical staging of Parkinson’s Disease.
What are some principles for enhancing function in Parkinson’s Disease patients?
- Cueing
- Dual tasking
- Balance training
- Gait re-education
- Symptom-specific exercise.
What types of exercise have been shown to improve function in Parkinson’s Disease?
- Pilates
- Yoga
- Dance
- PD Warrior.
4 types of MS
Benign, relapsing remitting, secondary progressive, primary progressive
