week 13: Multiple Sclerosis
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Questions and Answers

What is Multiple Sclerosis?

  • a genetic disorder affecting muscle function
  • an inflammatory disease of the central nervous system (correct)
  • a degenerative disease that affects sensory-motor function
  • a viral infection of the brain that impact nerve conduction

    • What is the primary target of the immune system in multiple sclerosis?

  • myelin sheath (correct)
  • neuronal cell bodies
  • synaptic cleft
  • axon terminals

    • What is a role of myelin in the nervous system?

  • to produce neurotransmitters
  • to generate action potentials
  • to form synaptic connections
  • to facilitate rapid transmission of electrical impulses (correct)

    • What is a primary pathological feature of multiple sclerosis?

    <p>formation of plaques or scleroses in the central nervous system</p> Signup and view all the answers

    How does demyelination in Multiple Sclerosis affect neural communication within the central nervous system?

    <p>it disrupts the insulation of axons, slowing or blocking the conduction of nerve signals</p> Signup and view all the answers

    What characterises relapsing-remitting MS (RRMS)?

    <p>periods of neurological worsening followed by remissions</p> Signup and view all the answers

    What is the role of oligodendrocytes in the nervous system?

    <p>to produce and maintain myelin in the central nervous system</p> Signup and view all the answers

    What is a common cognitive symptom of multiple sclerosis?

    <p>Difficulty with memory and information processing</p> Signup and view all the answers

    Which of the following is considered a primary benefit of exercise for individuals with Multiple Sclerosis?

    <p>reduced fatigue and improved gait</p> Signup and view all the answers

    What is the Uhthoff phenomenon in Multiple Sclerosis

    <p>a temporary worsening of neurological symptoms due to an increase in body temperature</p> Signup and view all the answers

    Where is the most common place for an MS patient to develop a lesion during the course of disease?

    <p>Spinal cord</p> Signup and view all the answers

    All symptoms can be exacerbated by ___

    <p>heat</p> Signup and view all the answers

    Match

    <p>Relapsing remitting MS = characterized by periodic exacerbations followed by full or partial recovery of deficits Primary progressive MS = characterized by continuous disease progression from onset with little or no plateaus or improvements Secondary progressive MS = initially characterized by relapsing-remitting course followed by primary progressive course Progressive relapsing MS = characterized by a progression from onset with distinct relapses superimposed on the steady progression</p> Signup and view all the answers

    Betaseron, Avonex, and Capaxone are only useful in relapsing-remitting MS

    <p>True</p> Signup and view all the answers

    Which of the following is not a motor symptom of multiple sclerosis?

    <p>Numbness or tingling</p> Signup and view all the answers

    Cognitive symptoms in multiple sclerosis include memory problems and difficulty concentrating.

    <p>True</p> Signup and view all the answers

    What autoimmune response occurs in multiple sclerosis?

    <p>The immune system attacks myelin.</p> Signup and view all the answers

    Which symptom is associated with optic neuritis in multiple sclerosis?

    <p>Blurred vision</p> Signup and view all the answers

    Demyelination in multiple sclerosis results in improved nerve signal transmission.

    <p>False</p> Signup and view all the answers

    Name one possible environmental factor that may influence multiple sclerosis susceptibility.

    <p>Infections or vitamin D deficiency.</p> Signup and view all the answers

    What type of multiple sclerosis is characterized by a steady progression of symptoms?

    <p>Primary Progressive MS</p> Signup and view all the answers

    What percentage of people diagnosed with multiple sclerosis are women?

    <p>75%</p> Signup and view all the answers

    The average age of diagnosis for multiple sclerosis is younger than 25 years.

    <p>False</p> Signup and view all the answers

    What is the primary characteristic of Multiple Sclerosis (MS)?

    <p>Demyelination of nerve fibers</p> Signup and view all the answers

    What type of MS is most common in young adults?

    <p>Relapsing-remitting MS</p> Signup and view all the answers

    Match the following MS treatments with their primary features:

    <p>Betaseron = Interferon beta-1b for reducing relapse rate Avonex = Interferon beta-1a administered weekly Copaxone = Glatiramer acetate to prevent attacks Tysabri = Monoclonal antibody for severe MS forms</p> Signup and view all the answers

    Which of the following statements about exercise for individuals with MS is true?

    <p>Exercise can improve functional capacity and quality of life for individuals with MS.</p> Signup and view all the answers

    The Uhthoff phenomenon describes a persistent increase in symptoms without changes in temperature.

    <p>False</p> Signup and view all the answers

    What affects the autonomic dysfunction in individuals with MS during exercise?

    <p>Impaired thermoregulation, blunted heart rate, and blood pressure response.</p> Signup and view all the answers

    Exercise has no effect on disease progression in persons with Multiple Sclerosis.

    <p>True</p> Signup and view all the answers

    Study Notes

    Motor Symptoms

    • Muscle weakness
    • Muscle stiffness (spasticity)
    • Problems with coordination
    • Abnormal gait

    Sensory Symptoms

    • Numbness and tingling
    • Pain, including neuropathic pain

    Cognitive Symptoms

    • Memory problems
    • Difficulty concentrating
    • Executive function disorders

    Vision Symptoms

    • Optic neuritis (inflammation of the optic nerve)
    • Blurred or double vision

    Other Symptoms

    • Chronic fatigue
    • Bowel and bladder dysfunction (incontinence, urgency or retention issues)
    • Emotional changes (depression, anxiety, mood swings)

    Pathophysiology

    • Immune system attacks myelin (protective sheath of nerve fibers)
    • This causes the formation of lesions (plaques) in the central nervous system (CNS)
    • Nerve signal transmission is slowed or interrupted

    Neurodegeneration

    • Axons and neural tissues are damaged over time
    • Disease progression can lead to permanent disability

    Types of Multiple Sclerosis

    • Relapsing-Remitting MS (RRMS): Relapses with new symptoms, followed by periods of recovery
    • Secondary Progressive MS (SPMS): Follows RRMS, with a gradual worsening of symptoms
    • Primary Progressive MS (PPMS): Steady progression of symptoms from onset, without relapses

    Other Factors

    • Infections (e.g. Epstein-Barr virus)
    • Vitamin D deficiency
    • Genetics may play a role, but no single gene has been identified.

    Introduction to Multiple Sclerosis (MS)

    • MS is a chronic, inflammatory disease of the central nervous system (CNS)
    • It is characterized by disseminated demyelination of nerve fibers in the brain and spinal cord
    • It is the most common cause of neurological impairment in young adults worldwide
    • The impact of MS is significant due to its unpredictable disease course and variable symptoms
    • There is no known cure for MS, and most cases progress to disability
    • Treatments are available to slow the progression of the disease

    MS Statistics in Australia

    • More than 23,000 people have been diagnosed with MS in Australia
    • Around 1,000 more people are diagnosed each year
    • The age of onset is between 20-50 years in 85% of cases
    • The average age of diagnosis is between 25-35 years old
    • 75% of those diagnosed are women

    Economic Impact of MS

    • The total cost of MS in Australia is $1.04 billion per year
    • $500 million is due to lost productivity
    • 50-80% of people with MS cease working full-time within 10 years of diagnosis
    • The replacement cost of informal care provided to Australians with MS is $125 million
    • Australians with MS pay $78 million per year out of their own pockets

    Pathophysiology of MS

    • MS is considered an inflammatory autoimmune disease of the CNS
    • It is characterized by random nerve axon demyelination
    • Axons are spared from the disease processes, but inflammation may damage nerves
    • Multiple areas of scarring (sclerosis) and plaque formation occur, slowing or blocking nerve conduction
    • These events can potentially occur anywhere within the white matter of the CNS

    Nerve Cell Structure and Function

    • Nerve cells (neurons) are responsible for transmitting signals throughout the body
    • The basic structure of a neuron includes a cell body, dendrites, and an axon
    • The myelin sheath, a fatty substance, covers the axon and facilitates the rapid transmission of nerve impulses

    Oligodendrocytes

    • Oligodendrocytes are the myelinating cells of the CNS
    • Composed of 80% lipid and 20% protein
    • Each cell may support up to 40 neurons
    • Myelin supports saltatory conduction and efficient neural communication

    Common Sites for MS Lesions

    • MS lesions can occur in various parts of the CNS, including the brain, spinal cord, and optic nerves
    • The location of lesions influences the type of symptoms experienced
    • Common sites for MS lesions include the optic nerves, brain stem, cerebellum, and spinal cord

    Associated Signs and Symptoms of MS

    • MS can cause a wide range of signs and symptoms, including:
      • Visual disturbances (e.g., blurred vision, double vision, optic neuritis)
      • Motor impairments (e.g., weakness, spasticity, tremors, fatigue)
      • Sensory disturbances (e.g., numbness, tingling, pain)
      • Cognitive impairment (e.g., memory problems, concentration difficulties)
      • Bowel and bladder dysfunction
      • Depression and anxiety

    General Risk Factors for MS

    • Age, sex, family history, exposure to infection, race, and climate are all general risk factors for developing MS
    • The exact cause of MS is still unknown, but genetics and environmental factors are believed to play a role
    • Research suggests that individuals with a family history of MS have a higher risk of developing the disease

    Diagnosis of MS

    • The diagnosis of MS is typically based on clinical history, neurological examination, and various diagnostic tests, including:
      • Magnetic resonance imaging (MRI) scans to detect lesions in the CNS
      • Cerebrospinal fluid (CSF) analysis to identify inflammatory markers
      • Evoked potentials to assess nerve conduction
    • The diagnosis can be challenging, as MS symptoms often mimic other conditions
    • A definitive diagnosis usually requires evidence of multiple lesions in different areas of the CNS over time

    Clinical Course of MS

    • The clinical course of MS is unpredictable and varies widely among individuals
    • It is characterized by periods of relapse and remission, where symptoms worsen and then improve
    • Some individuals experience a more gradual progression of disability, while others may experience periods of significant disability

    Treatment of MS

    • There is no cure for MS, but various treatments are available to manage the disease and slow its progression
    • Medications used to treat MS include:
      • Disease-modifying therapies (DMTs), such as interferon beta, glatiramer acetate, and natalizumab, to reduce the frequency and severity of relapses
      • Corticosteroids to reduce inflammation and improve symptoms during relapses
      • Immunomodulators, such as alemtuzumab and fingolimod, to suppress the immune system
    • Other treatments include physical therapy, occupational therapy, and speech therapy to address physical limitations, mobility problems, and communication difficulties
    • Lifestyle modifications, such as regular exercise, a healthy diet, and stress management, are also recommended

    Medications and Potential Side Effects

    • The medications used to treat MS can cause various side-effects
    • These include:
      • Flu-like symptoms
      • Injection site reactions
      • Fatigue
      • Liver problems
      • Mood changes
      • Skin reactions
      • Infections
    • It is important to discuss the potential side effects of medications with your doctor.

    Summary

    • MS is a chronic, progressive disease of the CNS
    • It has significant economic costs for individuals and the health care system
    • MS lesions can occur in various parts of the CNS, with random locations
    • MS is associated with numerous signs and symptoms impacting sensory-motor, cognitive, and emotional function
    • Age, sex, family history, infection, race, and climate are general risk factors
    • Diagnosis involves electrophysiological and neuroimaging techniques as well as physical exams
    • Treatment aims to slow progression with anti-inflammatory agents such as interferon and corticosteroids, and symptom reduction

    Benefits of Exercise in MS

    • Exercise has no effect on disease progression.
    • Exercise helps to improve:
      • Cardiorespiratory capacity
      • Muscular strength
      • Flexibility
      • Physical function
      • Balance
      • Mobility
      • Mood
      • Self-report fatigue

    Effect of Aerobic Training On Gait And Maximal Exercise Tolerance In Multiple Sclerosis

    • Participants: 11 (8 Female / 3 Male), aged 20-55 years.
    • EDSS Range: 1-4
    • Aerobic Training (AT) resulted in improvements in:
      • Walking distance and speed
      • Max work rate
      • Aerobic efficiency
    • Increased disability (higher EDSS) resulted in greater gains from AT
    • NR (No intervention) resulted in no improvement in outcomes.

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    Related Documents

    EHR525 Week 13 Lecture 1 - Pathophysiology of Multiple Sclerosis (Charles Sturt University) PDF
    EHR525 Week 13 Lecture 2- Exercise for Multiple Sclerosis (1 Slide) PDF

    Description

    Test your knowledge on Multiple Sclerosis with this quiz that covers the immune system's impact, the role of myelin, and key features of the disease. Explore various aspects such as cognitive symptoms and the influence of exercise on MS. Ideal for students and healthcare professionals alike!

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