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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 fibres 100,000 people affected in the UK Cause unknown No Cure

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An Introduction to Multiple Sclerosis

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  1. An Introduction to Multiple Sclerosis

  2. What is MS? • Common symptoms. • Diagnosis & potential treatments. • Case Studies • Support for people with MS and carers

  3. 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

  4. Causes Research suggests a combination of genetic and environmental factors: • Genetics • Climate/ geography • Viruses/ bacteria?

  5. Prevalence of MS - Worldwide

  6. Diagnosis • Clinical examination • MRI– visualisation of inflammation • Evoked potentials- measure speed of nerve conduction • Lumbar puncture

  7. MS – What is happening?

  8. 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

  9. 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

  10. Myelin Sheath

  11. Symptoms Relapses Permanent disability Lost messages

  12. What types of MS? • Relapsing Remitting • Secondary Progressive • Primary Progressive • Benign

  13. Relapsing Remitting MS Primary Progressive MS 4 types of MS Benign MS Secondary Progressive MS

  14. MS Management • Main types • Relapse treatments • Symptom treatments – Quality of Life • Disease Modifying Drugs

  15. Common symptoms • What are the common symptoms of MS?

  16. Common symptoms • Spasticity/Spasm • Pain • Depression • Cognition • Personality changes • Loss of mobility • Speech • Swallowing • Visual problems • Sensory problems • Fatigue • Vertigo • Bladder problems • Bowel problems • Sexual problems • Tremor

  17. MS & Fatigue • Most common symptom - variable • Overwhelming, unrelated to physical activity • Cannot be seen by you • Affects thought, vision, physical abilities ~~ • Heat • Physical exertion • Infection • Disturbed sleep • Medication • What to do? • Understand variety • Go at the person’s rate – plan activities etc • OT can assess

  18. 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.

  19. Wider consequences • Psychological impact (depression/ cognitive problems) • Loss of mobility • Home • Relationships and family • Finances (Incl. insurance) • Employment issues • Unplanned hospital admissions

  20. Case studies

  21. 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.

  22. Safeguarding & Capacity • Safeguarding • Mental Capacity Act • Capacity Assessment • Best Interests • DOLS • Court of Protection & OPG

  23. Good Practice My care needs can & will change – sometimes overnight! MS effects people differently Remember the MS Nurse Not all changes may be due to MS Be responsive, flexible and ready to adapt to changes. Let’s discuss contingency plans in regards to any changes in need It is obvious – but listen to me

  24. MS Society Support • Education & Information • Service Development • Professional Network • Policy & Campaigns • Grants to Individuals • Peer Support • Branch Networks • Research • Fundraising • Voluntary Opportunities

  25. Thank You!

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