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Multiple Sclerosis

Multiple Sclerosis. Claire Hamshire. Definition. “ An acquired inflammatory demyelinating disease of the central nervous system”. Aetiology and Epidemiology. Cause – unknown Environmental and genetic factors implicated Female : Male ratio Age. Classifications. Benign

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Multiple Sclerosis

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  1. Multiple Sclerosis Claire Hamshire

  2. Definition “An acquired inflammatory demyelinating disease of the central nervous system”

  3. Aetiology and Epidemiology • Cause – unknown • Environmental and genetic factors implicated • Female : Male ratio • Age

  4. Classifications • Benign • Relapsing / Remitting • Secondary progressive • Primary progressive

  5. Pathology

  6. MS Disease Process

  7. Diagnosis • Neurologist • Tests – MR scan, lumbar puncture • Differential diagnosis

  8. MS cat scan

  9. Clinical features (variable) • Sensory problems • Motor problems • Bladder / bowel dysfunction • Fatigue • Heat sensitivity • Cognitive / emotional dysfunction • Sexual dysfunction

  10. Secondary complications • Disuse atrophy • Abnormal tone • Pain • Contractures • Pressure sores • Chest infections • UTI

  11. Aims of Physiotherapy The course of the disease cannot be influenced by physiotherapy, however we can help to: • maximise function • maintain and increase ROM • prevent secondary complications • prevent contractures • maintain and encourage weight bearing

  12. Physiotherapy Management Education Treat clinical signs Consider type of disease progression Consider stage of disease Open access Open access team approach Consider carers Employment Moving and Handling Aids and adaptations Palliative Monitoring / Outcome Measures

  13. Aspects of treatment • Modulate abnormal muscle tone • Facilitate normal movement • Balance re-education • Increase co-ordination • Stretching programme • Management of fatigue • Pain control • Relaxation • Walking aids • Pelvic floor rehabilitation • Functional exercises

  14. M.S. Society Guidelines • Standards of healthcare for people with M.S. • Basics of best practice in the management of M.S. • People with M.S. in long term care www.mssociety.org.uk

  15. Standards of healthcare for people with M.S. • Access • Support • Information • Informed advice • Treatment and self management - responsive - co-ordinated

  16. N.I.C.E clinical guidelines • CSP and RCP professional leads • Broad range of care services • Different forms of M.S. • Interaction with Social Services / Voluntary sector • Diagnosis, Drugs, Rehabilitation, Alternative Therapies • Prevention of secondary problems • Management of Impairment and Disabilities www.nice.org.uk

  17. Drug Therapy • Anti inflammatory & Immunosupression - steroids - Azothiopine, Methotrexate • Immuno modulation - Beta-interpheron

  18. MS case / video • Watch the video • Information in study pack - “Jackie” • Task in study pack

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