Summary phys.theory: MS introductie

Phys theory: MS: intro
Disease course & global evaluation

 Chronic progressive disease with inflammation and degeneration processes in the brain and spinal cord
 Leasie in hersenen
 Leaie in RM= meer impact dan in motor area’s
- Veel tracts multiple tracts
- MS=white matter aangevallen (myeline)
- RM= weinig / geen mogelijkheid neuroplast.
- MS= kan nog neuroplast. Zijn
 Hypertonia/spast in MS ≠ hersenen of RM leasie
- RM meer gelokaliseerd in een reflexogene manier
- Type/pheothype
- In RM= meer prob onder leasie
- Meer risico spasme abductie &flex&extensie
 Diagose moet snel gesteld worden
 Kripen hersenen= mindr plek voor uitvoeren complexere taken
- Geen neuroreserve meer
 Diagnose kan makkelijker & technischer gemaakt worden
- Vroeger = min 2 symptome vertonen
 Vaak pas zeer laat diagnose krijgen
- Vroeger minder gefocusd op sec. progressie
 Meer op relapsing-remitting
- CIS clinically important symptoms (figuur)

 Differentiation between inflammation and degeneration
- Manifistations in P are different
- Lot of inflammation -> medication
- If not it is a questionmark…
- With matter lesions on the T2 scan, it can also occur in the SC

1. DIFFERENT TYPES OF MS
 ‘Relapsing-remitting’ versus
‘progressive MS’
 ‘Active’ versus ‘non-active’
 The classification that we know now,
but this will change, there are
researches happening
 CIS can be active or not active
 When the symptom doesn’t come back
it is not active
 Active can lead to a RRMS when it does
come back several times
 RRMS
- Active: a lot of lesions in the brain
that progress
- Not-active: not that much lesions in the brain, and no progression in the brain

 Active & met progressive
- Active= Elke 2 j. scan & verergering zien
- Progressive= symptome




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, Phys theory: MS: intro




1.1. PROGRESSIVE MS




1.2. RRMS – PIRA
 Progression In absence of Relapse Activity
 PIRA: there can be a progression happening but very
subtle
 Typically in RRMS
 We should measure the activity and the progression to
know how the patient is doing
 Behavioural changes that may be happening
 T25-FW=time 25 foot walk
- 7.62m zo snel mogelijk
- Wandelsnelheid
 Misschein eerder kijken naar activiteit ipv progressie




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, Phys theory: MS: intro

2. CLINICAL COURSE OF MS
 Future: new names and terms
 Maybe the 2 questionmarks will emerge
 There is always a progression?




 Neurodegenerative disease: it is present in the early phase but not realy visible, think about PIRA!
 Health behaviour: smoking is proven to be very negative for your progression
 Not every patient benefits from drugs (medication)

3. Disease Modifying drugs (DMD) for RRMS / PMS




4. SYMPTOMS
 Veel invissible symptomen
- Cogitieve functie,…
 Fatigue= numer 1
 Ahankelijk per P welke symptomen
 Pijn
- Neuorplastisch
- Neuropatisch
 Emotional changes

 Symptomen
- Fatigue
- Weakenss
- Spasms
- Cognition
- Depression
- Reduced walking
- Sensory-loss
- Balance problems
- Increased temperature will lead to a worse performance
- Dual tasking problems
 Symptom interconnectivities

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