Kristin CasagrandOctober 25, 2011

Overview and Treatment of Multiple Sclerosis

Disease Overview Most widespread cause of

neurological disability worldwide

“Multiple”- many affected locations possible

“Sclerosis”- hardened plaque in form of scars/lesions, from attacks on the CNS

http://econnect.uspharmacist.com/

What causes MS?

Autoimmune hypothesisAntibodies attack

oligodendrocytes demyelination

Leads to conduction blockage or slowed impulse transmission

http://www.msif.org

Who develops MS?

Caucasians twice as likely as other races

Women twice as likely as men

http://i.dailymail.co.uk/

Types of MS

Relapsing-remitting Secondary progressive Primary progressive Progressive-relapsing

http://www.websters-online-dictionary.org/

Symptoms Variable in every patient Poor posture and balance Pain Spasticity Fatigue Heat intolerance

Exacerbates symptoms (heat causes even slower transmission in demyelinated areas)

www.examiner.com

Treatment 2 categories

Disease modifying vs. Optimizing functional capacity Ideally should begin after first definite attack

To minimize spreading and damage Treatment =

Improvement of attacks Management of symptoms Prevention of relapse and progression Rehabilitation

Disease Modifying- Drug Treatment

Immunotherapy Interferon Copolymer-1

Decreased lesion count, 30% reduction in relapse rate, delay to clinical progression (Soldan and Rodriguez, 2002)

www.msconnections.org

Drug Treatment- Interferon beta

Proven improvement

in survival rates for patients

undergoing interferon

beta treatment

http://www.ucsf.edu/

Disease Modifying- Transplantation

Transplanting oligodendrocytes To enhance myelin repair in CNS

Stem cell transplantation Contain myelin-producing cells Long term study of 21 adults (also

given standard therapy)- none saw further deterioration over 3 yr period

http://www.healthcarecentraltexas.com/

Optimizing Capacity- Physical Therapy

Main general goals Improve or maintain mobility and

balance Build tolerance for activity Reduce symptom impact

Provides task-specific stimuli for neural reorganization

Electrical stimulationhttp://www.tcpalm.com/

Optimizing Capacity- Occupational Therapy Main general goals

Helping patients lead independent lives

Compensating for limiting disabilities

Daily modifications Energy conservation

Designing equipment for everyday functionality

http://www.mscentrebedsandnorthants.com/

Acknowledgements

GHS Acute Care PT Staff Lori Taggert

GHS Outpatient PT Staff GHS Inpatient Rehabilitation

Staff Lori Godbee

Susan Ybarra