Transcript: Sources WebMD Mayo Clinic Discovery Health Definition MS existed long before it was named 1433= First possible MS patient recorded 1868= Dr. Jean- Martin Charcot discoveres the disease By: Gracie Miller Multiple Sclerosis (MS) is a dehibilitating disese where the immune system eats away at myelin. Myelin= the protective coating surrounding nerves. New medicine research: Toxavin Symptoms Numbness in limbs Partial-complete loss of vision Pain during eye movement Tingling and pain in parts of body Sensations of shock accompanying head movement Unsteady gait Fatigue, dizziness Relapses and partial remission are common Not known May be related to hereditary or childhood infections Miscellaneous Interferon beta drugs- control immune system Corticosteroids- most common Physical therapy Muscle relaxants There is no cure. 4 types, most common is relapsing- remitting (attacks followed by remission) Others are: Progressive-relapsing, Primary progressive, and Secondary progressive Cause No way to prevent disease No way to prevent attacks- may be triggered by rising body heat Treatment News Prevention History Multiple Sclerosis
Transcript: multiple sclerosis some treatments are: avonex, rebif, tysabri, gilenya, these wont cure ms (there is no cure) but they might help but also have very risky side effects Blurry vision joint pain fatigue dizziness loss of cordination symptoms a non cureable disease the test we took where: RBC:4.7 million WBC:7,000 hemoglobin:14.0 normal The test we did were : MRI:lesions found Spinal tap:positive EPT:positive multiple sclerosis is a potentially debilitating disease that effects your immune system differential diagnosis Multiple Sclerosis we also thought anna had anemia body systems treatment diagnosis the systems that are effected are the brain and nervous systems. the brain will have lesions or plaques that effect the bodys motion
Transcript: Multiple sclerosis (MS) is a potentially debilitating disease in which your body's immune system eats away at the protective sheath that covers your nerves. This interferes with the communication between your brain and the rest of your body. Ultimately, this may result in deterioration of the nerves themselves, a process that's not reversible. Signs and symptoms of multiple sclerosis Numbness or weakness in one or more limbs, which typically occurs on one side of your body at a time or the bottom half of your body Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement (optic neuritis) Double vision or blurring of vision Tingling or pain in parts of your body Electric-shock sensations that occur with certain head movements Tremor, lack of coordination or unsteady gait (the way locomotion is achieved using human limbs) Fatigue Dizziness Most people with multiple sclerosis, particularly in the beginning stages of the disease, experience relapses of symptoms, which are followed by periods of complete or partial remission. Signs and symptoms of multiple sclerosis often are triggered or worsened by an increase in body temperature. The cause of multiple sclerosis is unknown (idiopathic). It's believed to be an autoimmune disease, in which the body's immune system attacks its own tissues. In multiple sclerosis, this process destroys myelin — the fatty substance that coats and protects nerve fibers in the brain and spinal cord. Myelin can be compared to the insulation on electrical wires. When myelin is damaged, the messages that travel along that nerve may be slowed or blocked. Risk Factors include: Being between the ages of 20 and 40 Being female Having a family history. If one of your parents or siblings has had multiple sclerosis, you have a 1 to 3 percent chance of developing the disease — as compared with the risk in the general population, which is just a tenth of 1 percent. Having certain infections Being white Living in countries with temperate climes. Multiple sclerosis is far more common in Europe, southern Canada, northern United States, New Zealand and southeastern Australia Complications: Muscle stiffness or spasms Paralysis, most typically in the legs Problems with bladder, bowel or sexual function Mental changes, such as forgetfulness or difficulties concentrating Depression Epilepsy Test and diagnoses: Blood tests Spinal Tap (lumbar puncture)- A doctor or nurse removes a small sample of cerebrospinal fluid from within your spinal canal for laboratory analysis. MRI Treatments and drugs: Even though there is no known cure for Multiple Sclerosis there are medicines to help treat attacks: Corticosteroids Plasma Exchange Drugs to help with Symptoms Physical Therapy Muscle relaxants such as baclofen (Lioresal) and tizanidine (Zanaflex) Multiple Sclerosis
Transcript: Multiple Sclerosis CNS: Central Nervous System -brain -spinal chord -optic nerves The path over which a nerve signal travels is protected by insulation (myelin). This is what is damaged in MS patients, and it's thought to be made by a confused immune cells. The immune cells eat away the myelin as well as the spindle, wire-like nerve fibers.With inflammation continuing to occur, nerve signals are interrupted. Symptoms vary from mild to very severe and affect people between the ages of 20 and 40... •fatigue, usually during the afternoon, even after sleep •heat sensitivity •numbness & dizziness/vertigo, impaired thinking •bladder and bowel dysfunction •tremor or muscle spasms, increased spasticity •impaired mobility •optic neuritis-vision problems •swallowing disorders An Imperfect System.. MRI-can show scar tissue and lesions LUMBAR PUNCTURES- examine the cerebrospinal fluid of the spinal cord BLOOD SAMPLES electrical NERVE TESTS and... a COMPLETE medical history There is no cure.. BUT the ulrtimate goal is to slow the progress of MS and help you to live as normal a life as possible. E.G. Interferon drugs, daily physical therapy, a healthy diet. Meds can be given as needed to help with symptoms. The Endddd:) If two of the previously mentioned conditions are present see a neurologist. It's been suggested that people who get MS are born witha genetic predisposition to react to an environmental agent Gentically speaking, 2nd and 3rd degree relatives are more at risk than say, sisters and brothers sclerosis is actually another name for scar tissue (that forms over damaged myelin) you're my cousin? The Causes..
Transcript: Ishwinder, Mehali, Sana Thanks for Listening! Multiple Sclerosis Treatment Bibliography http://www.msstrength.com/avonex-for-mu http://www.mayoclinic.com/health/medical/IM00962ltiple-sclerosis/ http://www.health.com/health/library/mdp/0,,zm6056,00.html http://www.visualphotos.com/image/1x8466985/tem_of_myelin_sheath http://www.mayoclinic.com/health/medical/IM00962http://www.msconnections.org/ • Destruction of myelin (2012), multiple sclerosis (MS), Encyclopaedia Britannica, Volume 1, http://school.eb.com/article-9054246 Marshall Cavendish, (1996), Multiple sclerosis, encyclopedia of life science, volume 9, page 1175, New York, London, Toronto, Sydney President and fellows of Harvard college, (August 21, 2006), Multiple Sclerosis (MS), book and fact sheets, http://www.nmss.org/ Organs Affected usually occurs between the age of 20 -40 affects more women than men patients still have a normal life expectancy, quality of life may decrease in most cases, there is evidence of a genetic component over a million people affected worldwide more common in temperate regions, than tropical more common in Europeans, less common in Africans/Asians Causes Causes Organs/ Organ Systems Affected Interesting Facts ORGANS/ORGAN SYSTEMS AFFECTED • 95% of the people diagnosed live a normal life •Some could be unable to walk, write or speak. •But most of the patients are rarely affected. •People with controlled symptoms tend to do fine than the ones who have uncontrolled chronic symptoms. •The symptoms can be taken control of by rest, good nutrition and less stress. - difficult to diagnose as symptoms might be recognized as other diseases/conditions - needed to diagnose: medical history, standard neurological examination, several lab tests lab tests include: MRI A lumbar puncture Evoked potential tests -can affect a person's ability to move, feel, and to control body functions tingling numbness dizziness vision problems fatigue Organ Systems Affected Symptoms can develop in four types of patterns: Relapsing remitting Primary progressive Secondary progressive Progressive relapsing Diagnosis Pictures (Sources) •Brain •Optic nerve •Spinal Cord multiple sclerosis is a progressive autoimmune disease myelin sheaths that surround neurons (brain cells) are being destroyed, exposing and damaging the axon of neurons affects the central nervous system • no cure • drugs like Avonex, Betaseron, and Rebif could be used to control the chronic symptoms • rehabilitation and supportive measures could be a part of the treatment. Possible Outcomes What is Multiple Sclerosis Treatment What is Multiple Sclerosis? Possible Outcomes Interesting Statistics • Three Goals of drug therapy are: 1. Acute episodes 2. Prevention of disease progression 3. Treatment of Chronic symptoms • Symptoms that can be treated include: o Muscle spasticity o Depression o Pain o Tremor o Fatigue o Bladder and bower dysfunctions. Drug Therapy •central nervous system Diagnosis Type of Diagnosis
Transcript: M.S effects the body in multiple way ranging from effecting the -Muscular Systems: -Bowel and Bladder: -Vision: -Speech and swallowing: -Sexual : -Cognitive: -Death/Complication: •Multiple sclerosis." PubMed Health. National Center for Biotechnology Information, U.S. National Library of Medicine , 26 2011. Web. 5 Dec 2012. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001747/>. •Senelick, Richard. "Multiple Sclerosis Spinal Tap Test, Diagnosis, Results." WebMD. WebMD, 31 Aug. 2012. Web. 13 Dec. 2012. •Reece, Jane B., Martha R. Taylor, Eric J. Simon, and Jean L. Dickey. Campbell Biology, Concepts & Connections. 7th ed. Boston: Benjamin-Cummings Pub Co, 2012. Print. •"National Multiple Sclerosis Society." Pregnancy and Reproductive Issues : National MS Society. Nation Multiple Sclerosis Society, n.d. Web. 13 Dec. 2012. Chipps, E. M., N. J. Clanin, and V. G. Campbell. Neurological Disorders. St. Louis, MO: Moby-Year Book, Inc., 1992. Print. Citation Page The History of Multiple Sclerosis Personal Experiences *Mimics Symptoms *Ruling Out Other Disorders *Central Nervous System Connections The Science behind the Disease What are the Warning Signs As of now M.S is an no known cure for it. However there are treatment plans to help slow the progression of the disease. -Medication: -Steroids: -Physical Therapy: -Assisted Living: -Changing in diet and living style: *Age *Gender *Family *Location Factor *Myelin Sheath *Varieties of Severity What Happens to the Body? In order to be sure that you have MS a series of test can be run including Neurological Exams Optical Exams Other test include Lumbar taps and MRI's 1868-Jean-Martin Charcor "father of neurology" Test for diagnosis How Can it Be Treated? Multiple Sclerosis By Emma Guider And Jennifer Stein
Transcript: “Recently noticed increasing levels of tiredness at the end of the day” - book appointments at middle or start of day Daily routine- work, son, meal times - book appointments around these The appointments would not want to be too vigorous for long periods of time Timing of physiotherapy appointment 50 year old with a 5 year history of MS Works as a secretary and has noticed an increased levels of tiredness at the end of the day Doesnt have any interest in going to the gym but enjoys walking She also has an 18 year old son who lives at home (suspects he has been smoking) Common Medications for MS MS and cigarette smoking Advice for Pam about her son Medication History of a patient with MS Meet Pam Pam's Case Pam's Case Aerobic Exercises Strengthening and balance Medication of MS may cause side effects like flu-like symptoms, loss of appetite, anxiety, nausea and vomiting. Interferon – released in response to the entry of the virus. Side effect: flu-like symptoms such as fatigue, chills and fever Imuran – immune suppressing drug, can halter attack of the immune system on nerves. Side effect = fatigue Muscle Spasticity – sustained stiffness due to increase muscle tone -The intensity can vary due to different body positions, state of relaxation and different posture Baclofen is a muscle relaxant that restores imbalance of the electrical signals which allows more normal muscle movements. Key objectives of the exercise programme Multiple Sclerosis Pam's sudden Heart Rate (HR) drop Sit to stand – ½ squats Toe and heel raises Wall push-ups Tandem stance walking up and down the hall (only when accompanied by physio) The Programme Cardiac Dysautonomia Caused by lesions in the brain which 10-15% of MS patients get. Dysautonomia is an imbalance between the sympathetic and parasympathetic nervous systems of the autonomic nervous system. Dysautonomia causes fluctuations in the HR response to stimuli such as exercise In Pam's case with the Borg RPE scale she had a "10" on the modified scale this is classed as "very, very strong almost maximal exertion" indicating that she felt extremely exhausted with the exercise test. Increase cardio-respiratory fitness Help increase ability to perform everyday activities Long term benefits Maintain or improve current muscular strength Maintain or improve balance Berg Balance test = 45/56 Resting Heart rate = 72bpm BMI = 28 kg/m2 classed in the overweight category Exercise test = 5 minute walk, HR decreased to 60bpm, and rose to 100bpm after 1 minute on a treadmill. Modified Borg scale ="10" It is important to use HR monitoring to ensure safety of Pam The use of other methods to monitor the body homeostasis control is important as it allows the physio to have a better understanding of how the body is functioning under the pressure of exercise The use of the Borg RPE scale is very useful to determine the intensity The Modified Borg scale is from 0-10 with 10 = "very, very strong almost maximal" exertion Need to ensure that the room is standardized with regards to temperature, humidity and how relaxed the environment is. MS is an autoimmune disease, where the body's immune cells attack the nervous system; This causes inflammation resulting in demyelination of axons Communication between cells is slowed and or stopped altogether; symptoms include: fatigue muscle weakness loss of coordination and balance altered sensation Causes of MS The cause of MS is still unknown but suggestions such as environmental cues, viruses and or genetic factors are being researched. Exercise Programmes in MS patients Heart Rate Questions? Smoking can lead to MS susceptibility Smoking can lead to symptoms of MS worsening at a faster rate Assessment Results Results from her tests "MS patients have been shown to make favourable improvements in cardiorespiratory fitness in as little as 4 weeks." (White and Dressendorfer, 2004) What is Multiple Sclerosis (MS)? Fatigue is one of the main symptoms of MS- 80% have it Rest is an important part of fatigue management Mental fatigue normally follows a daily pattern, and many MS patients have reported that they “feel fine during the first few hours of the day but, afternoon or early evening, feel completely exhausted.”- http://www.mult-sclerosis.org/fatigue.html Physical fatigue can be easily induced by small amounts of physical activity. Pam performed an exercise test, where she walked for 5 minutes at her natural walking speed. At the end of the test, her heart rate dropped down to 60bpm (below her resting HR of 72bpm) and then rose back up to 100bpm after 1 minute of rest. She also experience a "10" on the modified Borg Scale 2x5 minutes outside walking with 10 minute rest in between. Cycle on the stationary bike – 2x5 minutes with 10 minute break. Swimming Stair walking – up and down two flights, few minutes break then up and down again. Regular breaks are important Progression What questions relating to medication history should the physiotherapist ask Pam and what
Transcript: PATHOLOGY/PROGRESS OF THE DISEASE A genetic disease that is caused by an immune response. 1-2 Million People Worldwide (20-40 years old) Women are twice as likely to be affected as men The risk for developing it is fifteen times higher if a first-degree relative has MS. *Myelin*Oligodendrocytes *Lesions*Plaques* Myelin is destroyed. This causes conduction abnormaties or blocks in the Central Nervous System. Oligodendrocytes are destroyed. These cells create myelin, so when they are destroyed, no more myelin can be formed. Lesions occur in two stages. The first stage involves the development of small, inflamed lesions. In the second stage, the lesions extend and form together. This creates scar tissue. Plaques are hard, demylinated, sclerotic patches that tend to form on the optic nerves, brain stem, cerebellum, periventricular white matter, and spinal cord white matter. COMMUNITY RESOURCES ALTERNATIVE THERAPIES MEDICATIONS FOR MS COST OF THE DISEASE COMPLICATIONS OF MS ETHICS AND LEGAL ISSUES MULTIPLE SCLEROSIS ETHICS AND LEGAL ISSUES CHALLENGES OF THE DISEASE BEST PRACTICE INTERVENTIONS
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