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Losdigity72
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Intention tremors, scanning speech, nystagmus are all symptoms of what disease and make up what triad
Multiple Sclerosis
Charcot's Triad
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The t-lymphocytes damage what portion of the CNS
the myelin sheath
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Multiple Sclerosis typically involves what structures of the CNS
- brain
- spinal cord
- optic nerves
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Gliosis, selective demyelination, inflammation hardened plaque and gliosis are all characteristics of what pathology
MS
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During relapse of MS what must be avoided during PT rehab
aggresive exercises
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What are the predictors for a good outcome for MS
- onset with only 1 symptom (strong indicator)
- benign, RRMS
- complete recovery after attacks
- onset<40 years
- MRI findings low active lesions, mild axonal loss
- neurological findings at 5 yrs is good predictor
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What are predictors of bad outcome
- progressive course
- onset >40 yrs
- significant pyramidal, cerebellar signs at 5 yrs
- (nystagmus, tremor, ataxia, dysarthria)
- high frequency of attacks
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What are the most common symptoms of MS
- fatigue 88%
- gait problems 87%
- bowel/bladder problems 65%
- pain & other sensations 60%
- visual disturbance 58%
- cognitive 44%
- tremors 41%
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What are some general info/stats for MS
- 20-40 Yrs rare in children and >50yrs
- females>male, cauacasians
- life expectancy not reduced
- death secondary infection
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What are areas of the globe that have a higher frequency of MS diagnoses
- Northern US/Southern Canada
- Scandinavia
- Northern Europe
- New Zealand/Southern Australia
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What are the risk factors for MS
- 0.1% no other family member
- 1% father has MS and baby is boy
- 2% mother has MS and baby is girl
- 3% if sibling has MS
- 5% if fraternal twin has MS
- 25% if identical twin has MS
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What are some other risk factors for MS
- smoking, vitamin d deficiency
- viral agents such as (Epstein-Barr virus, measles, canine distemper, human herpevirus-6 chlamydia pneumoniae
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What percentage of viral infection triggers MS
33%
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What areas of the CNS are more greatly affected by demyelination
- optic nerves
- periventricular white matter
- spinal cord (corticospinal tract, posterior white columns)
- cerebellar peduncles
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What are the percentages of axonal loss with mild and severe MS
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How is MS diagnosed
There is no specific test, an MRI of the CNS showing evidence of at least 2 damaged areas, damage occurs in 2 seperate points in time that are at least 1 month apart
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What is looked for in the CSF for MS
increased immunoglobulin and oligoclonal bands
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Which subtype of MS accounts for less than 20% of all MS cases in which the patient remains fully functional in all neurological systems 15 years after onset
Benign
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This subtype of MS is very rare is also known as Marburg disease. It has a rapid onset with continuous progression leading to significant disability and/or death in a short time
Malignant
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This subtype of MS has clearly defined exacerbations of neurological deficits, followed by partial or complete recovery in subsequent weeks to months. Remission time periods ar characterized by lack of disease progression and is the most common at time of diagnosis
Relapse-Remitting
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This subtype of MS is slow with continuous worsening symptoms, no distinct relapses or remission which is associated with a later onset and is least common
Primary progressive
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This subtype of MS initially starts as RRMS has a cahnge of clinical course from steady progressive and irreversible decline, which may be due to progressive axonal loss rather than new lesions
Secondary-progressive
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This subtype of MS has a steady deterioration from onset, it has occasional clear acute relapse, in between relapses disease progression continues and is the least common form
Progressive-Relapsing
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An Pseudoexacerbation such as heat is also known as
Uthoffs Syndrome
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What is optic neuritis
Inflammation of the optic nerve. It may cause sudden, reduced vision in the affected eye
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What Diminished acuity
acuteness or clearness of vision, which is dependent on optical and neural factors
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What is Marcus Gunn pupil
Its a medical sign observed during the swinging-flashlight test whereupon the patient's pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye.
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What is internuclear ophthalmoplegia
is a specific gaze abnormality characterized by impaired horizontal eye movement with weak adduction of the affected eye and abduction nystagmus of the contralateral eye
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What is diplopia
double vision, is the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, or diagonally (i.e., both vertically and horizontally) in relation to each other.
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What is Dysdiadochokinesia
an impaired ability to perform rapid, alternating movements
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What is dysarthria
difficulty saying words because of problems with the muscles that help you talk.
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What is dysphonia
difficulty speaking because of dystonia (muscle spasms)
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What is dysphagia
difficulty swallowing
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interferon beta 1b & 1a are indicated for which type of MS
RRMS
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Novatrone is indicated for what form of MS
SPMS, PRMS and worsening RRMS
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Baclofen, tizanidine, diazepam, tegretol and botulin toxin are all forms of what type of medications for MS to treat
spasticity and spasms
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What are some surgical interventions for MS
- tendon release
- neurectomy
- rhizotomy
- nerve blocks
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What are some PT interventions for MS
- Strength trng & Cardio conditioning
- Flexibility exer.
- fatigue and spasticity mgmt
- balance & coordination trng.
- gait trng.
- functional mobility trng.
- H2O therapy
- pain treatment
- safety trng
- compensatory strategies for sensory deficits
- adaptive equip,ent trng.
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What are some Short Term Goals for MS patients
- Increasing/maitaining ROM, strength, endurance, functional mobility improving ADL's
- energy conservation, compensatory training, increasing activity level with tolerance
- educate on skin care due to sensory loss
- fit & educate on proper equipment
- educate patient, family, friends on disease process, exacerbating factors, realistic expectations, community resources, promote emotional and social adjustments
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What are some Long Term Goals for MS
- Maximize functional status & independence
- prevent/slow development of 2° impairments
- promote emotional/social adjustments for patient and family
- minimize complications 2° to decreased mobility
- compensate for loss function
- Ed. energy conservation techniques especially during exacerbations
- maintain employment as long as possible
- Ed. psychosocial adjustments, vocational trng.,
- family issues maximize rehab gains
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