Transcript MS_Overview_IRHA 2015v2 FINAL

Panel discussion:
MS: Would you know it if you
saw it? Early diagnosis,
treatment, and resources for
patients
Illinois Rural Health Association
Peoria, Illinois
August 13, 2015
Our Panelists
Tamara Lott, LCPC
One Counseling & Wellness, Washington, IL and
Illinois Neurological Institute MS Center, Peoria, IL
• Supporting someone living with a chronic illness
• Importance of early diagnosis and treatment
Dennis Garwacki, MD, neurologist and director
Illinois Neurological Institute MS Center, Peoria, IL
• What is MS
• Treatment options
Suzanne Carron, OTR/L, Dir. Community Partnerships &
Programs, Gateway Area Chapter
Kendall Hugel, Clinical and Community Services Specialist,
Greater Illinois Chapter
NMSS Staff
• Resources for Patients
• Resources for Healthcare Professionals
Who gets MS?
• Usually diagnosed between 20 and 50
 Occasionally diagnosed in young children
• More common in women than men (2-3:1)
• Most common in those of Northern European
ancestry
 More common in Caucasians than Hispanics or
African Americans; rare among Asians
• We know that 340 individuals with MS, who selfidentified with the MS Society, live in rural
communities as identified by the MS Society
criteria.
How important is early treatment?
• The Society’s National Clinical Advisory Board
recommends that treatment be considered as soon as
a dx of relapsing MS has been confirmed.
 Irreversible damage to axons occurs even in the earliest
stages of the illness.
 Tx is most effective during early, inflammatory phase
 Tx is least effective during later, neurodegenerative phase
• No treatment has been approved for primaryprogressive MS.
• Treatment includes: relapse management,
symptom management, disease modification,
rehabilitation, emotional support.
*The Use of Disease-Modifying Therapies in Multiple Sclerosis: Principles and Current
Evidence. A Consensus Paper by the Multiple Sclerosis Coalition – March 2015
Emotional Changes and MS
•
•
•
•
•
•
•
•
Adjusting to the diagnosis
Generalized distress and anxiety
On-going losses
Depressive episodes and some less severe
depressive symptoms
Stress and reactions to stressful situations
Emotional lability or mood swings
Pseudobulbar affect
Inappropriate behavior
What MS Is:
• MS is thought to be a disease of
the immune system—probably
autoimmune.
• The primary targets of the
autoimmune attack are the
myelin coating around the nerves
in the central nervous system
(CNS—brain, spinal cord, and
optic nerves) and the nerve fibers
themselves.
• Its name comes from the scarring
caused by inflammatory attacks
at multiple sites in the central
nervous system.
How is MS diagnosed?
• MS is a clinical diagnosis:
 Signs and symptoms
 Medical history
 Laboratory tests
• Requires dissemination in time and space:
 Space: Evidence of scarring (plaques) in at least
two separate areas of the CNS (space)
 Time: Evidence that the plaques occurred at
different points in time
• There must be no other explanation
What are possible symptoms?

MS symptoms vary between individuals and are unpredictable






Fatigue (most common)
Decreased visual acuity,
diplopia
Bladder and/or bowel
dysfunction
Sexual dysfunction
Paresthesias (tingling,
(numbness, burning)
Emotional disturbances
(depression, mood swings)







Cognitive difficulties
(memory, attention,
processing)
Pain (neurogenic)
Heat sensitivity
Spasticity
Gait, balance, and
coordination problems
Speech/swallowing
problems
Tremor
How is the disease course treated?
• 12 disease-modifying therapies are FDA-approved for relapsing
forms of MS:
 interferon beta-1a (Avonex® and Rebif®) [inj.]
 interferon beta-1b (Betaseron® and Extavia®) [inj.]
 glatiramer acetate (Copaxone®) [inj.]
 fingolimod (Gilenya®) [oral]
 natalizumab (Tysabri®) [inf]
 mitoxantrone (Novantrone®) [inf]
 teriflunomide (Aubagio®)[oral]
 dimethyl fumarate (Tecfidera®)[oral]
 Interferon beta1a (Plegridy®)[inj]
 Alemtuzumab (Lemtranda™[inf]
What do the disease-modifying
drugs do?
• All reduce attack frequency and severity, reduce
scarring on MRI, and probably slow disease
progression.
• These medications do not:
 Cure the disease
 Make people feel better
 Alleviate symptoms
Society Resources for Your Patients
•
•
•
•
•
35+ chapters around the country
Newly-designed Web site www.nationalMSsociety.org
Access to information and referrals (1-800-344-4867)
Educational programs (in-person, online)
Connection programs (self-help groups, peer and
professional counseling, friendly visitors)
• Consultation (legal, employment, insurance, longterm care)
• Financial assistance
What can you do for people affected by
MS?
• Give them access to the National MS Society through
1-800-344-4867 to reach a Service Navigator; no one
needs to be alone in coping with MS.
• Refer to a MS neurologist for definitive diagnosis and
treatment (NMSS Partners in MS Care)
• Consult with the Professional Resource Center for
assistance
• Make connections
Addressing the Challenges:
MS Centers
Partners in MS Care specialize in diagnosis, management, and treatment
MISSOURI:
and of MS
•
•
•
•
•
•
*Pediatric MS Centers
St. Louis Children’s
Hospital
John L. Trotter MS Center at Washington University
Saint Louis University Department of Neurology
Veteran’s Administration Medical Centers: at John Cochran
The MS Center of Saint Louis at Mercy Medical Center
MS Center for Innovations in Care at Missouri Baptist
Saint Luke's Marion Bloch Neuroscience Institute: Multiple
Sclerosis Center, Kansas City, MO
ILLINOIS:
• Consultants in Neurology, Wilmette, IL
• Consultants In Neurology, Northbrook, IL
• Illinois Neurological Institute Multiple
Sclerosis Center, Peoria, IL
• Neurologic Associates, Ltd., Palos Heights, IL
• NorthShore University HealthSystem Multiple Sclerosis
Center, Evanston, IL
• Northwestern University Medical Center, Chicago, IL
• Rush University Medical Center, Chicago, IL
• University of Chicago MS Center, Chicago, IL
Society Resources for Healthcare
Professionals
• Professional Resource Center
• Website: http://www.nationalmssociety.org/For-Professionals
Email: [email protected]




Comprehensive MS library/literature search services
Clinical consultations with MS specialists
Professional publications
Professional education programs (medical, rehab,
nursing, mental health)
 Consultation on insurance and long-term care issues
 NMSS app  search for MS Society