Download - An Introduction to Multiple Sclerosis
An Introduction to Multiple Sclerosis
What is MS?
Common symptoms.
Diagnosis & potential treatments.
Case Studies
Support for people with MS and carers
Multiple Sclerosis
An autoimmune condition - nerve fibres100,000 people affected in the UKCause unknown No CureUsually diagnosed from 20-40 yrsNot contagious Not fatal – life expectancy reduced ~ 5-10 years
Causes
Research suggests a combination of genetic and environmental factors:
• Genetics
• Climate/ geography
• Viruses/ bacteria?
Prevalence of MS - Worldwide
DiagnosisClinical examination
MRI– visualisation of inflammation
Evoked potentials- measure speed of nerve conduction
Lumbar puncture
MS – What is happening?
Central Nervous System
The brain and spinal cord are surrounded by the blood brain barrier (BBB)• Lets in e.g. oxygen & sugar • Keeps out e.g. viruses & bacteria
Few immune cells enter the CNS
In MS the blood brain barrier breaks down
Skin barrier breaks down
Immune cells move to the area causing redness and swelling (inflammation)
Immune cells identify “foreign material” and destroy it
Healing or scar development
Myelin Sheath
Permanent disability
SymptomsRelapses
Lost messages
What types of MS?
Relapsing Remitting
Secondary Progressive
Primary Progressive
Benign
4 types of MSRelapsing
Remitting MS Primary
Progressive MS
Benign MS Secondary Progressive MS
MS ManagementMain types
• Relapse treatments
• Symptom treatments – Quality of Life
• Disease Modifying Drugs
Common symptoms
What are the common symptoms of MS?
Common symptomsVisual problems Sensory problemsFatigueVertigoBladder problems Bowel problemsSexual problems Tremor
Spasticity/Spasm PainDepressionCognitionPersonality changesLoss of mobilitySpeechSwallowing
MS & FatigueMost common symptom - variableOverwhelming, unrelated to physical activityCannot be seen by youAffects thought, vision, physical abilities
~~HeatPhysical exertionInfectionDisturbed sleepMedication
What to do?Understand variety
Go at the person’s rate – plan activities etc
OT can assess
MS & Cognition
As many as 65% affected
Learning and memory (recent events and remembering to do things)
Attention, concentration and mental speed
Problem solving
Word finding
Things that make it worse are often some of the symptoms of MS.
Wider consequencesPsychological impact (depression/ cognitive problems)Loss of mobilityHomeRelationships and familyFinances (Incl. insurance)Employment issues Unplanned hospital admissions
Case studies
Mental Capacity Act 2005
The five key principles in the Act are:Every adult has the right to make his or her own decisions and must be assumed to have capacity to make them unless it is proved otherwise. A person must be given all practicable help before anyone treats them as not being able to make their own decisions. Just because an individual makes what might be seen as an unwise decision, they should not be treated as lacking capacity to make that decision. Anything done or any decision made on behalf of a person who lacks capacity must be done in their best interests. Anything done for or on behalf of a person who lacks capacity should be the least restrictive of their basic rights and freedoms.
Safeguarding & Capacity
Safeguarding
Mental Capacity Act
Capacity Assessment
Best Interests
DOLS
Court of Protection & OPG
Good Practice
MS effects
people
differently
Be responsive, flexible and ready
to adapt to changes.
My care needs can & will change
– sometimes overnight!
Not all
changes
may be due
to MS
Remember the MS Nurse
It is obvious –
but listen to meLet’s
discuss
contingency
plans in
regards to
any changes
in need
MS Society SupportEducation & InformationService DevelopmentProfessional NetworkPolicy & CampaignsGrants to IndividualsPeer SupportBranch NetworksResearchFundraisingVoluntary Opportunities
Thank You!