welcome to today’s webinar: learn about multiple sclerosis
TRANSCRIPT
Welcome to today’s Webinar: Learn about multiple sclerosis
Your Presenter is: Dr Marion SimpsonYour Facilitator is: Annie Sassin
Multiple Sclerosis Limited
Acknowledgement
We acknowledge and pay respect to the traditional custodians past
and present on whose lands we meet today.
We acknowledge the deep feelings of attachment and the
relationship of Aboriginal people to country and respect the
cultural authority of the elders in each community
Multiple Sclerosis Limited
Introduction to Presenter
Welcome to Dr Marion Simpson. Marion graduated with honours from the
University of Edinburgh in 2004. She undertook postgraduate training in
Edinburgh and Glasgow and completed the MRCP (UK) examination before
migrating to Australia in 2007.
Marion completed her neurology specialist training at the Austin and Alfred
Hospitals and currently holds a Consultant Neurologist appointment at the
Austin Hospital. Marion is also in the process of completing a Doctorate of
Medical Sciences in the area of Symptomatic Treatments in Multiple
Sclerosis. Within the field of neurology, Marion has particular interest and
expertise in stroke, multiple sclerosis and neurophysiology.
Multiple Sclerosis Limited
Informed Choice
This presentation has been prepared and is presented by an
independent expert.
The views presented are not necessarily the views of Multiple
Sclerosis Limited.
Individuals are encouraged to seek further advice regarding the
relevance of the information presented for their situation.
Dr Marion Simpson
Consultant Neurologist
Multiple Sclerosis (MS) is a
chronic inflammatory disease of
the central nervous system.
(brain, spinal cord & optic nerves)
What is MS?
women 3:1 men.
average age of diagnosis is 37 years*
There are approximately 24,000 Australians
with MS
“Everyone Knows Someone with MS”
Who gets MS?
*Ausimmune study 2010
ENVIRONMENTGENETICS
CHANCE
MS
World Distribution of MS
• nerves are covered in a myelin sheath
• the myelin sheath becomes inflamed
• signals along nerve pathway become
interrupted
• inflammation causes scarring of myelin
• damage occurs at a number of different sites in
the CNS & at different times
• the nerve itself may also be damaged
What is MS?
Disease Process
Healthy Nerve
Inflammation
Axonal damage
How is MS Diagnosed?
Lumbar puncture
MRI
Evoked Potentials
Examination findings
Clinical SymptomsDIAGNOSIS
MRI
Relapsing/
Remitting
__________
Primary
Progressive
__________
Secondary
Progressive
__________
Progressive
Relapsing
Disease Course
85%
10%
5%
Symptoms
Blurred or
double vision
Loss of balance
or coordination
Weakness in the
arms or legs
Sensory changes
Heat intolerance
Problems with speech,
slurring and/or swallowing
Pain
Continence
problemsTremor
Spasticity
Sexual problems
Fatigue
Cognitive, mood,
behaviour change
MS symptoms
Brain & cerebellum
cognitive impairment
depression
coordination problems
tremor
Spinal cord
weakness
spasticity (stiffness, painful spasms)
bowel / bladder problems
sexual problems
Brainstem
vision problems
vertigo
speech disorders
swallowing disorders
sensory loss & pain
Optic nerve
Blurred or double
vision, vision loss
Other
common
symptoms
fatigue
heat
sensitivity
What is a relapse?
Relapses last at least 24 hours
Symptoms depend on brain region affected
Must rule out pseudo-relapse (infection, fever, other illness)
Usually at least a month apart from previous relapse (often longer)
Treatments Network of Professional Support
GP
Neurologist
MS Nurse
Physiotherapists
Occupational therapists
Speech Pathologist
Psychologist
Social Worker
Drug Therapy
Drug therapy
• MethylprednisoloneSteroids
• Injections: Copaxone, Rebif, Betaferon, Avonex, Plegridy, Zinbryta
• Tablets: Gilenya, Tecfidera, Aubagio
• Infusions: Tysabri, Lemtrada, Ocrevus
Disease modifying therapies
• Mitozantrone (Novantrone)
• Methotrexate
Immune suppressants
Symptomatic Treatment• Gabapentin, pregabalin
• Amitryptiline, duloxetine
• Cannabinoids?
• Opiates
Pain
• Oxybutinin
• Botulinum toxin
• Intermittent Self-Catheterisation
Bladder & bowel
problems
• Modafinil
• AmantadineFatigue
Symptomatic Treatment
• FampridineWalking difficulty
• Antidepressants
• AnxiolyticsMood disorder
• Baclofen
• Muscle relaxants
• Physiotherapy
Spasticity
Neurologist’s Tasks
Make diagnosis
Ensure patient on correct medication Disease-modifying treatment
Symptomatic treatments
Perform monitoring (MRI, examination)
Educate patient and family members
Liaise with MS nurse and allied health professionals
Provide patient access to information and treatment
Stay up to date with developments in field
Participate in research
Patient’s tasks
Inform neurologist of symptoms Work with neurologist and MS nurse to find suitable
treatment Take treatment! Speak up regarding symptoms and other difficulties Look after general health
Diet Exercise No smoking
Stay well-informed about disease and developments Participate in research
Multiple Sclerosis Limited
Questions
MS Connect
1800 042 138
Multiple Sclerosis Limited
The National Disability Insurance Scheme
A major change to the way disability supports and services are funded
and delivered
• Available to people who are: under 65, satisfy residency requirements and are able to
demonstrate that their disability substantially affects daily living
• Promoting choice, control and social and economic participation
• Providing a whole-of-life approach
• It is not means tested
• Providing reasonable and necessary supports and services
• Ensuring equity of access
Multiple Sclerosis Limited
We can help you to:
• understand the eligibility requirements
• understand the pathways to access the NDIS
• prepare for a planning conversation
• understand your current supports and any unmet need
• develop your goals
Multiple Sclerosis Limited
We are a ‘Registered Provider’
MS is a registered NDIS provider in NSW, ACT and Vic and awaiting registration in Tas. MS is
approved to provide:
• Preplanning prior to your conversations (All areas)
• Support Coordination/Connection – assistance to help make your plan active (All areas)
• Short term accommodation (Vic)
• Community Participation (NSW)
• Exercise physiology and personal training (NSW)
• Specialist Continence Assessment (NSW and Vic)
• Physiotherapy and Occupational Therapy (NSW and Vic)
Want to learn
more?
Please call
MS Connect
1800 042 138
Multiple Sclerosis Limited
Thank you
MS Connect
1800 042 138
Education