NeuroPT - 22 - MS

females

MS is more common in (males/females)

20-40

MS has a typical onset between the age of _____-_____

farther

there is an increased prevalence of MS (closer/farther) the equator

epstein barr virus

the ____________ caused an increased risk of MS by 32x

autoimmune, selective demyelination

MS is an _________ process causing _____________ that affects the white matter of the CNS

TRUE

T/F: the disease course for MS is highly variable between individuals

• CIS

• RRMS

• SPMS

• PPMS

the 4 types of MS are:

optic nerve

the ________ is the only part of the peripheral nervous system affected by MS

CIS

______ MS is the first episode of symptoms

24 hours

CIS MS has to last at least _____

monofocal

(mono/multi)-focal CIS is a single system, like optic neuritis

multifocal

(mono/multi)-focal CIS is optic neuritis with numbness/tingling

MRI activity

CIS with __________ is much more likely to develop MS within several years

relapsing remitting RRMS

______ is the most common initial type of MS diagnoses

secondary progressive SPMS

_______ is the type of MS that most people with RRMS progress to

TRUE

T/F: there can be progression of the MS with SPMS without symptoms being present

MRIs

routine _____ are important for patients with MS

primary progressive PPMS

________ is the subtype of MS with accumulation of symptoms without early relapses or remissions

spinal cord

PPMS more commonly affects the (cortical area/spinal cord)

• dissemination in space (2 different places in the brain)

• dissemination in time (2 separate times of MRI activity)

the two main diagnostic criteria for a diagnosis of MS are:

• ______________

• ______________

symptoms

the locations of MRI lesions with MS correspond directly to __________

medial longitudinal fasciculus

the _______________ coordinates eye movements, and 40-75% of people with MS have difficulty with this causing double vision

• optic nerves

• posterior columns

• corticospinal tracts

• cerebellar peduncles

• medial longitudinal fasciculus

common areas of impact for ME: (5)

FATIGUE

a very common symptom of MS that needs to be managed is ___________

HEAT

MS is fatigue and symptoms are exacerbated by _______

nearly all of them possible EXCEPT

• hypokinesia

• perceptual deficits

• verticality deficits

which movement system diagnoses may be possible with MS:

disease modifying drugs

the treatment approach for MS long term is ____________

>24 hours

a relapse or acute exacerbation of MS is defined as new or increased symptoms lasting _______

pseudo relapse

a __________ of MS is symptoms lasting less than 24 hours and are usually caused by exercise, heat exposure, fatigue, or UTI

immunomodulators

pharmaceutical management for MS called ________________ can be used via injections, oral medications, or infusions

ocrevus

_______ is the only FDA approved med for PPMS

CNS getting infected

using pharmaceuticals and disease modifying medications like immunomodulators for MS causes an increased risk for ______________

effective

the big trade off with meds for MS is that safe meds aren’t very __________

diagnosis

for MS, it is recommended to start disease modifying drugs at ____________

• failure to control disease

• side effects are intolerable

• adverse event

  • fatal brain infection by JC virus

• inability to follow treatment regimen

• more appropriate treatment becomes available

disease modifying drugs for MS should be continued indefinitely UNLESS: (read)

ampyra

_______ is a medication specifically FDA approved to improve gait speed and endurance for people with MS

NOT

a person living with MS (would/would not) have perceptual deficits

• timed 25 ft walk

• modified fatigue impact scale

• 12 item MS walking scale

three MS specific outcome measures are:

research

the clinical disability EDSS for MS is most commonly used in the ________ setting

deposit, save, spend

fatigue MANAGEMENT (not conservation) can be thought of as a bank where there is ______ energy, ________ energy, and _________ energy that essentially goes by the week

• sleep hygiene

• REGULAR EXERCISE

people with MS can deposit energy into their bank through: (2)

• compensatory strategies (bracing, AD, WC, DME)

• manage heat/stress

people with MS can save energy in their bank through: (2)

• delegate tasks to others as able

• consider big events within the week

people with MS can spend energy strategically from their bank through: (2)

FAMILIAR

if someone is treating patients with MS, they need to be _________ with MS

autonomic dysfunction

people with MS can have blunted _______________ with exercise training, causing abnormal pressor response, blunted CV response to exercise, and syncope

RPE

you should always use _____ and monitor closely when doing exercising training for people with MS

good, bad

people with MS have _____ days and _____ days and may need different DME depending on the day