MS pathos

how does MS impact a person?

physically, psychologically, socially, vocationally

neuron

electrically excitable nerve cell

each neuron contains a cell body

myelin

covers axons

made of lipids and proteins

serves as an insulator

conducts nerve signals

• the more myeline the faster the conduction rate

what happens during MS relating to neurons

neurons run down myelin, jump across at nodes of ranvier

as myeline disintegrates, synapse is not able to occur like it should

brain communication down to limbs to move is delayed

relapsing remitting MS

fluctuation course of relapse

              stages of where we have symptoms ofMS, and then relapse or go into remission to where the symptoms are not as pronounce. Remission and exacerbations (symtpoms are a lot worse/manifestations)

secondary progressive

slow deterioration and progression of disease. Fluctuations stop. Slow deterioration, relapsing remitting progresses to secondary

Can take anywhere from 20-40 years for this to occur

primary progressive

get the symptoms and they are with us for the rest of our lives and continue to progress

initial manifestations of MS

diverse, unpredictable

varies: not all experience the same manifestations or progression of the condition

initially— very subtle

often fluctuate and may involve: sensory or visual concerns, fatigue, weakness, and impaired balance or coordination

MS is usually disease of the ___

UMN

systemic changes of MS

Fatigue, limited endurance, heat sensitivity

sensory manifestations of MS

decreased sensation/numbness, pain, paresthesia (numbness or tingling)

vision MS

optic neuritis (transient visual manifestation—> dimness, blurring, pain), diplopia (double vision), partial visual loss, nystagmus(pupils jerking in directions bc they are trying to focus)

motor manifestations MS

muscle weakness or partial or complete paralysis

spasms with associated cramps

ataxia , tremor- head or hands, vertigo, spasticity

speech and swallowing with MS

slurred speech, dysarthria, dysphagia, scanning speech

dysarthria

unclear articulation

cognitive changes with MS

attention, conceptualization, memory, new learning

potential manifestations of MS

depression

bowel and bladder control- neurogenic bladder, incontinence

sexual function and fertility

fatigue

identification and confirmation of MS

No definitive lab

full neurological exam

MRI, evoked potential, cerebrospinal fluid collection and exam (ruling out other diseases)

look at nerve impulse

managing systematic manifestations MS

individualized plan, maintain function, delaying/preventing exacerbations, nonpharmacologic approaches (health lifestyle, triggers, therapy) medication

chronic pain management MS

OT/PT, CBT, alternative treatment methods

management of motor difficulties MS

try to remain as active as possible without developing excessive fatigue

management of spasticity

pharmacologic and nonpharacologic

management of speech and swallowing options

SLP

exercises, positioning, safety, communication options

management of cognitive difficulties

neuropsychologist eval

strategies: making lists, keeping notes, avoiding distractions

bladder and bowel management

medications, catheters, restroom-schedule, fluids monitoring, constipations, alleviation

management of depression

psychological consolation, antidepressants, support

vocational issues in MS

unemployment and underemployment

giving strategies to modify work environment

identifying triggers