MS 3

Question 1

What are some of the main symptoms of MS?

Answer 1

• unilateral vision impairment
• paresthesia
• ataxia/unsteadiness
• vertigo
• fatigue
• bowel/bladder dysfunction
• speech impairment
• pain

Question 2

MS: ataxia is often present with

Answer 2

tremor

Question 3

Ataxia associated with MS: management

Answer 3

difficult to manage

Question 4

What is the single most common and disabling symptom of MS?

Answer 4

fatigue

Question 5

How does fatigue present with MS?

Answer 5

Overwhelming tiredness in those who have not exerted and are not depressed

Question 6

MS and repetitive tasks: how does this influence fatigue?

Answer 6

• demyelinating nerves fire over and over until it shorts when called to do a repetitive task
• exercise often results in feeling increased fatigue instead of strength

Question 7

Fatigue with MS is also related to ________ in addition to repetitive firing

Answer 7

sleep dysfunction

Question 8

Mm weakness is exacerbated by

Answer 8

heat

Question 9

What does cooling allow for with MS pts?

Answer 9

• more efficient nerve conduction

- improved strength

Question 10

Pain and MS pts:

Answer 10

• surprisingly common (up to 50% affected)

- Usually burning, neuropathic type

Question 11

What has led to the development of a whole new set of symptoms for MS pts?

Answer 11

Aggressive use of immunomodulating agents

Question 12

What are some of the signs of MS? (not to be confused with symptoms)

Answer 12

• optic neuritis
• nystagmus
• spasticity
• Babinski’s sign
• intention tremor
• labile or mood change
• Lhermitte’s sign

Question 13

Mood changes commonly seen

Answer 13

• Primary or secondary depression

- due to either actual bran changes and chemistry OR result of dx itself

Question 14

What is Lhermitte’s sign?

Answer 14

momentary electric-like shock that stops you in your tracks

Question 15

Lhermitte’s sign is evoked by:

Answer 15

• neck flexion

- cough

Question 16

Lhermitte’s sign can be related to

Answer 16

peripheral nerve dysfunction

Question 17

Lhermitte’s sign: cause for concern?

Answer 17

if combined with other s/s

Question 18

MS is characterized by: (BROAD)

Answer 18

progressive disability over time

Question 19

Benign course of MS (% affected)

Answer 19

20%

Question 20

What is often the FIRST manifestation of MS?

Answer 20

Optic neuritis

Question 21

How does optic neuritis often present with MS pts?

Answer 21

• unilateral painful decrease or loss of vision
• visual field defects
• decreased color vision
• reduced visual clarity

Question 22

Sensory changes with MS in initial stage

Answer 22

Paresthesia

• one extremity
• head/face