WEEK 5 MS Flashcards
(15 cards)
Define what MS is
MS is a chronic demyelinating disease of the Central Nervous System characterised by an inflammatory process and causing widespread degeneration of the CNS, gradually resulting in severe neurological deficit.
MS stands for Multiple Sclerosis.
Explain the pathophysiology of MS
Disruption of blood-brain barrier, leakage of inflammatory cells, destruction of oligodendrocytes and myelin sheath, disruption of nerve signals, and formation of plaques throughout the CNS.
‘Sclerosis’ means ‘scarring’, and ‘multiple’ refers to various scarring sites in the brain and spinal cord.
What are the common symptoms of MS?
- Fatigue
- Difficulty walking
- Vision problems (e.g., blurred vision)
- Problems controlling the bladder
- Sensory deficits
- Increased muscle tone
- Reduced balance
- Ataxia
- Problems with thinking, learning, and planning
These symptoms can vary in severity and may affect daily functioning.
How many people in the UK have MS?
Over 130,000 people, which is approximately 1 in every 500 people.
The incidence rate is 190 cases per 100,000 population.
What is the gender distribution of MS in the UK?
MS is more than twice as common in females than males, with rates of 272 versus 106 per 100,000 population.
This reflects a significant gender disparity in the prevalence of the disease.
At what age is MS generally diagnosed?
Between 20-40 years of age.
This age range indicates a peak incidence of MS in young adults.
What are some suspected triggers for MS?
- Environmental factors
- Viral factors
- Genetic factors
The exact cause of MS remains uncertain, but these factors may contribute to its onset.
What are the key components of MS diagnosis?
- Clinical history
- Neurological examination by a specialist
- MRI scan
- Evoked Potential tests
- Lumbar puncture
- Blood tests
No single test can conclusively diagnose MS; a combination of methods is used.
What factors are associated with a better disease course in MS?
- Being female
- Being less than 40 years old when diagnosed
- Having few 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
These factors can influence the progression and severity of the disease.
What is the average life expectancy for people with MS?
Around 5 to 10 years lower than average, but this gap appears to be getting smaller over time.
Advances in treatment and management may contribute to improved life expectancy.
What are the main benefits of Disease Modifying Drugs (DMDs) for MS?
- Fewer relapses
- Less severe relapses
- Reduced build-up of disability
DMDs work with different parts of the immune system to reduce inflammation in the CNS.
What constitutes 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
- Event is not due to fever or infection
- Onset must be at least 30 days after any prior attack
A single paroxysmal episode does not count as a relapse; multiple episodes over 24 hours can.
What treatments are available for managing MS symptoms?
- Anti-spasticity agents (e.g., baclofen, tizanidine)
- Neuropathic pain medications (e.g., Gabapentin, Pregabalin)
- Anti-depressants
- Analgesia
- Catheterisation
- PEG feeding
These treatments aim to alleviate various symptoms associated with MS.
What is the common treatment for an MS relapse?
- 5-day course of steroid tablets at home
- Injections of steroid medicine given in hospital for 3 to 5 days
Steroids are used to reduce inflammation during a relapse.
List some members of the multidisciplinary team (MDT) involved in MS care.
- MS Specialist nurse
- Community nurse
- Neurologist
- GP
- Occupational Therapist
- Dietitian
- Physiotherapist
- Social Worker
- Speech and Language Therapist
- Podiatrist
- Psychologist
A comprehensive approach to MS management involves various healthcare professionals.
