2. EXEMPLAR OF MULTIPLE SCLEROSIS INTRODUCTION AND ASSESSMENT

3.  Definition -chronic, autoimmune neurologic disease -affects myelin sheath -etiology: unknown

4.  Relapsing-remitting (RRMS) most common -attacks followed by recovery  Primary Progressive (PPMS) -gradual and steady neuro deterioration  Secondary Progressive (SPMS) -starts as relapse-remitting then becomes steadily progressive  Progressive-relapsing (PRMS) -frequent relapses with only partial recovery

5.  Age: 20 to 40/50 yrs. Old  Gender: F>M  Race: Caucasian RISK FACTORS  First degree relative  Genetic susceptibility  Environment- colder climate  Smoking  Exposure to viruses

6.  Patient History  Signs and Symptoms  -Mobility fatigue, balance, weakness, spasticity  -Sensory numbness, temperature sensitivity, vision  -Cognitive/Emotional impaired judgment, reasoning  -Bowel and Bladder Dysfunction  -Sexual Dysfunction

7.  http://www.5min.com/Video/Learning-to- Cope-with-Multiple-Sclerosis-264563718

8.  MRI of brain and spine  CSF: during an attack protein,slight WBC  CSF electrophoresis: myelin basic protein  IgG (oligoclonal) bands present  Various evoked potential tests  McDonald Criteria (4 criteria)