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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 fibres
100,000 people affected in the UK
Cause unknown
No Cure
Usually diagnosed from 20-40 yrs
Not 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
Diagnosis
Clinical 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
Symptoms
Relapses
Lost messages
Permanent
disability
What types of MS?
Relapsing Remitting
Secondary Progressive
Primary Progressive
Benign
4 types of MS
Relapsing
Remitting MS
Benign MS
Primary
Progressive MS
Secondary Progressive MS
MS Management
Main types
• Relapse treatments
• Symptom treatments – Quality of Life
• Disease Modifying Drugs
Common symptoms
What are the common symptoms of MS?
Common symptoms
Visual problems
Sensory problems
Fatigue
Vertigo
Bladder problems
Bowel problems
Sexual problems
Tremor
Spasticity/Spasm
Pain
Depression
Cognition
Personality
changes
Loss of mobility
Speech
Swallowing
MS & Fatigue
Most common symptom - variable
Overwhelming, unrelated to physical activity
Cannot be seen by you
Affects thought, vision, physical abilities
~~
Heat
What to do?
Physical exertion
Understand variety
Infection
Go at the person’s rate
Disturbed sleep
– plan activities etc
Medication
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 consequences
Psychological impact (depression/
cognitive problems)
Loss of mobility
Home
Relationships and family
Finances (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
Remember
the MS Nurse
MS Society Support
Education & Information
Service Development
Professional Network
Policy & Campaigns
Grants to Individuals
Peer Support
Branch Networks
Research
Fundraising
Voluntary Opportunities
Thank You!