Additional diseases the impact movement

What is the prevalence ranking for diseases that effect movement?

1. PD

2. CP

3. MS

4. MD

5. HD

6. MND

What is MS?

Multiple sclerosis - autoimmune disease

Own immune system attacks myelin sheaths in the spinal cord

Typically affects patients between 25-35

How is MS acquired?

Unknown - but women are 2:1 times more likely, caucasians are twice as likely too

Is MS genetic?

If both parents have MS, 20% - if you have an identical twin there is a 30% chance. More risk factors for urban settings

What are other MS risk factors?

if you are born aboce or below 40 degrees, your risk factors increases

Symptoms of MS?

Movement challenges, tingling across the body, pain, depression

What are the four types of MS?

CIS - clinically isolated syndrome

RRMS - relapsing remitting MS

SPMS - secondary progressive MS

PPMS - primary progressive MS

What happens in CIS?

First episode of MS, inflammation and demyelination. Some but not all progress to MS

What happens in RRMS?

85% of patients, has ‘attacks’, they have periods of stability and then can have relapses, RRMS can be active - new MRI activity, or not active

What happens in SPMS?

Starts as RRMS, but is more aggressive, does not go back to baseline

What happens in PPMS?

Worseining accumulation of disability without relapses or remissions, about 15%

How is MS treated?

Medications used in three ways:

1. Modify the disease course

2. Manage relapses

3. Manage symptoms

What is modifying the disease course?

Supressing the activity of the immune system to slow progressions.

Interferon 1a or 1b proteins injected. Glatiramer acetate can serve as a decoy for the immune system

How to manage MS relapses?

oral or IV corticosteroids - anti-inflammatory

Prednisone - steroidal anti-inflammatory

MS progression

Treatment of MS may involve the use of glutimer acetate, which resembles myelin protein, and may "decoy" the body's immune system.   

True

What is MND?

motor neuron disease - a group of siseases in which the motor neurones undergo degeneration and die

Symptoms of MND?

Weakness, muscle wasting, respiratiory failure leading to death in 2-5 years

What is happening in MND?

Disruption in signals between lower motor neurons and the muscle & upper motor neurons and the lower motor neurons

What causes MND?

5-10% genetic

90% are sporadic, MND linked to enzyme SOD1 that protects cells from death from ROS

What is the treatment for MND?

Riluzole - may block voltage gated Na channels, reducing glutamate release from motor neurons, glutamate is excitatory and reducing this may be protective.

Baclofen - GABA b agonist, inhibits spasticity

What is MD?

Muscular dystrophy - a group of disorders which involve progressive loss of muscle mass and loss of strength

Most common is Duchenne muscular dystrophy, impacting young boys but other variants can effect adulthood

Why are majority of MD patients men?

It is X-linked, caused by genetic mutations which interfere with muscle proteins

Symptoms of MD?

Pain and stiffness in muscles, difficult gait, walking on toes, learning disabilities, breathing may require assistance, eventually losing ability to walk

How is MD diagnosed?

Blood test for creatine kynase (CK), which is produced by damaged muscles, elevation in this can suggest MD

What drugs are being used for MD?

Corticosteroids - to slow progression and inflammation

Heart medications - if muscular dystrophy impacts the heart, using beta blockers

In Duchenne's MD, there is a lack of dystrophin complex present in skeletal muscles, which usually enables the smooth movement of contracting fibres.

True - MD question

What is CP?

Cerebral palsy - most common physical disability

caused by brain issues or injury before during or immediately after birth

What are MS symptoms?

Low muscle tone, muscle spasms, unable to hold up head, poor muscle control, development delated, feeding or swallowing difficulties

Treatment of CP?

Physical and occupational therapy, assistive technology, surgery, some medications to help with spasticity

Botulin toxin type A can affect spasticity

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