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Multiple Sclerosis
Brett Glover
Paramedic ’08
5/26/08
What is MS?

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MS is a chronic, often disabling disease that
attacks the CNS.
MS is thought to be an autoimmune disease.
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T- cells attack myelin that protects nerve fibers.
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T-cells also secrete chemicals that damage nerve fibers
Damaged myelin forms scars.
Damaged myelin sheath or nerve fibers cause nerve
impulses to be interrupted or distorted.
Four types of MS
Relapsing-Remitting MS
 Primary-Progressive MS
 Secondary-Progressive MS
 Progressive-Relapsing MS

Relapsing-Remitting MS
~ 85% of people who have MS are initially
diagnosed with R-R MS.
 Clearly defined attacks or worsening
neurologic function (relapses) followed by
periods of remission.

Primary-Progressive MS
~ 10% of people with MS are diagnosed
with P-R MS.
 Characterized by slowly worsening
neurologic function from the beginning of
disease process.

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No periods of relapses or remissions.
Secondary-Progressive MS

Following an initial period of R-R MS,
many people develop S-P MS.

Diseases worsens more steadily.
 May
have occasional flare-ups or minor remission
periods.
Progressive-Relapsing MS
~ 5% of people with MS are diagnosed
with Progressive-Relapsing MS.
 Steadily worsening disease from the
beginning.
 Includes clear attacks of worsening
neurologic function.
 Disease progresses with out remissions.

What Causes MS?

Still unknown, but scientists believe that a
combination of several factors may be
involved.
Immunologic
 Environmental
 Infectious
 Genetic

Immunologic

It is known that T-cells attack the myelin
sheath and nerve fibers

It is unknown what triggers this response
Environmental


Known to occur more often in areas far from the
equator.
Scientists believe that MS may be associated
with Vitamin D.



Vitamin D is thought to be beneficial to immune
function and may help protect against autoimmune
diseases.
Produced naturally when you are exposed to sunlight.
People who live closer to the equator are exposed to
more sunlight causing them to have a higher level of
vitamin D.
Infectious

Exposure to viruses, bacteria or other
microbes in childhood may increase your
chances of getting MS.
Viruses are well know to cause damage and
inflammation to the myelin.
 Over a dozen viruses and bacterias are being
investigated.

 Measles
and chlamydia.
Genetic
MS is not hereditary, but having an
immediate family member with MS
increases the risk.
 Some researchers believe that people are
born with a genetic predisposition to react
to other environmental factors that
possibly cause MS.

Who Gets MS?

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2.5 million world wide
400,000 in the United States
Caucasians are more likely to be diagnosed
At least 2/3 more likely to occur in women than
men
Most people are diagnosed between age 20 and
50
Risk is 1/750 in general population vs. 1/40 in
anyone who has an immediate family member
with MS
Signs and Symptoms

Fatigue

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Numbness of the face, body or extremities
Balance and coordination problems


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Difficulty in walking
Bladder dysfunction

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Most common symptom
Found in ~ 80% of MS Pt
Bowel dysfunction
Vision problems

Generally the first symptom of MS
Signs and Symptoms

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Dizziness and Vertigo
Sexual Dysfunction
Pain


Cognitive Function

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~55% complain of significant pain
Ability to learn, plan, organize and problem solve
Emotional changes
Spasticity

Feelings of stiffness and involuntary muscle spasms
Treatments

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There is no cure
Modifying the disease course
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Managing Symptoms

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Avonex, Betaseron, Copaxone, Novantrone, Rebif,
Tysabri
Physical therapy, occupational therapy, speech
therapy, cognitive rehab, vocational rehab
Emotional support

Stress management skills, dealing with mood swings
and depression
Old Theories

Owning a dog or small pet

Canine distemper
Allergies
 Exposure to heavy metals


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Mercury, manganese, lead
Aspartame
Bibliography

Bledsoe, Bryan. Porter, Robert. Cherry, Richard.
Paramedic Care: Principles and Practice. Vol. 5. Upper
Saddle River, NJ. 2006.

National Multiple Sclerosis Society.
www.nationalmssociety.org. 22 May 2008
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WebMd. www.webmd.com/multiple-sclerosis/default.htm.
24 May 2008