Coping with Symptoms of Multiple Sclerosis

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1 Coping with Symptoms of Multiple Sclerosis Josée Poirier B. Sc. Nursing, MSCN Outline What Is a Pseudo exacerbation? Awareness Advancement of Treatments Treatment of Symptoms Uhthoff s Phenomenon What is Lhermitte s Sign? Signs of Optic Neuritis Conclusion 1

2 Pseudo exacerbation A pseudo exacerbation is an increase in a symptom (numbness, leg spasms, increased fatigue, etc.) caused by an infection, such as a urinary infection or a fever. Once the infection is treated and the fever disappears, the symptoms decrease. Pseudo exacerbation Some factors can increase symptoms: Stress and anxiety Fatigue Menstrual periods Lack of sleep, etc. Awareness Awareness of what aggravates or triggers your symptoms can reduce your stress level considerably. In the early stages of MS, people usually pay more attention to small signs. The better you understand the disease, the easier it is to manage the symptoms. 2

3 Advancement of Treatments In the past 20 years, treatment of MS has made great strides. From 0 treatments in 1994, we now have 10 immunomodulators and one treatment that improves walking speed. We now treat people as soon as they have their first attack of MS. Advancement of Treatments Thanks to many clinical trials that some of you have participated in, there are many drugs that treat the progression of the disease and others that control pain, urinary problems, spasms, constipation, etc. The Goal of Treatment The goals of treatment are: Reduce the number, duration and severity of relapses Reduce the number of new lesions on the MRI Slow the progression of MS 3

4 Treatment of Symptoms There are many treatments for various symptoms of MS. This is why it is important to describe your symptoms accurately to help your neurologist choose the most appropriate drug to treat your problem. Treatment of Symptoms The drug selected will depend on the symptom described, so you need to describe your symptoms as accurately as possible. Just saying it hurts does not help because the cause of pain can be mechanical, muscle or joint related, neurological, etc. Treatment of Symptoms There are many pain treatments that are not specifically for MS. Burning sensations, pain, spasms, urinary problems, etc., are all symptoms that can be treated. There is no miracle treatment. Trial and error is often necessary. 4

5 Treatment of Symptoms Every person responds to drugs differently. Because symptoms are not the same from one person to the next, the treatments will vary. Do not compare your treatments with those of other people. Since there are many drugs, the choice may differ from one neurologist to the next. Uhthoff s Phenomenon Uhthoff s phenomenon is the result of delayed nerve conduction triggered by an increase in body temperature after sustained physical effort, prolonged sun exposure, a hot bath, a fever, etc. Dr. Uhthoff described it as a temporary worsening of vision in patients with optic neuritis. Uhthoff s Phenomenon When exercising, alternate cardiovascular exercises with muscle building exercises. Drink water and take breaks to let the body cool down. Avoid hot baths. No risk of aggravating MS or causing progression. It is not a relapse. 5

6 What Is Lhermitte s Sign? Lhermitte s sign is an electric like shock that can spread down to the toes when the head is flexed forward. The reason is simple: a cervical lesion caused by MS is activated when the head is flexed. It is not dangerous or anything to worry about. Lhermitte s Sign Lhermitte s sign can be inconvenient and even painful. Your neurologist can prescribe a drug that relieves the symptoms. Signs of Optic Neuritis Optic neuritis occurs frequently in multiple sclerosis. About 30% of people begin MS with an optic neuritis episode. It is important to recognize its signs so it can be treated properly. 6

7 Signs of Optic Neuritis Pain when moving the eye (about 70% of MS patients) Loss of central vision (scotoma) Reduced vividness of colours (red) Blurred, out of focus vision No redness in the eye, no tearing, no sign of infection 7

8 Optic Neuritis If the neuritis is severe, the person may see only a shadow with the eye. If movement causes pain and there is a substantial loss of vision, the neuritis is treated with oral or intravenous corticosteroids. Conclusion Multiple sclerosis is a complex disease with a wide variety of symptoms, different presentations, forms, etc. It is important to recognize the symptoms of the disease and see a doctor when necessary. Conclusion Multiple sclerosis evolves differently from one person to the next and changes over time for each person. It is practically impossible to predict how the disease will progress. You must avoid comparing your experience with that of other people. 8

9 Conclusion Research helps us target the causes and find increasingly effective drugs. Coping with MS: You need to maintain hope and a positive attitude. Is It a Symptom of MS? The symptoms you are experiencing may not all be related to MS. If you have any doubts, ask your nurse or neurologist. 9

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