Common Challenges in the Diagnosis and Management of MS
Jointly presented by The Johns Hopkins University School of Medicine
and The Institute for Johns Hopkins Nursing.
Summary
The management of patients with multiple sclerosis (MS) is often complicated by several important clinical considerations. Depression, fatigue, sleep disturbances, and cognitive impairment are common complications of MS. It may be difficult to identify MS at the earliest stages of the disorder, and to decide when treatment should be initiated for a patient with evidence of central nervous system (CNS) demyelination who does not meet the complete diagnostic criteria for MS. This activity presents 2 case studies that focus on common challenges in the diagnosis and management of MS. The first case study describes the evaluation of a patient with an initial episode suggestive of CNS demyelination. This case discusses clinical and radiographic considerations in the assessment of CNS demyelination and also considers some of the management options that are available for patients with symptoms suggestive of demyelination, but who may not meet the full diagnostic criteria for MS. The second case discusses the impact of cognitive impairment, fatigue, and depression in patients with MS and reviews management strategies for cognitive impairment. After completing this activity, participants should be better able to recognize and manage patients with these common MS-associated complications.
Goal
To provide neurologists, nurses, and healthcare professionals who care for patients with MS with up-to-date information on the treatment and management of MS.
Target Audience
This activity is designed for neurologists, nurses, and healthcare professionals who care for patients with MS. No prerequisites required.
Learning Objectives
At the conclusion of this activity, the participant should be able to:
- Identify noninvasive imaging techniques for the assessment and monitoring of neurodegeneration in patients with MS.
- Summarize the clinical course and prognosis of patients with MS.
The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing take responsibility for the content, quality, and scientific integrity of this CE activity.
CME Information
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide CME for physicians.
The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Credit Designation Statement
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This 1.6 contact hour Educational Activity is provided by The Institute for Johns Hopkins Nursing. Claim only those contact hours actually spent in the activity.
After reading this case module, participants may receive credit by completing the CE test, evaluation, and receiving a score of 70% or higher.
Release date: December 31, 2008. Expiration date: December 31, 2010.
Estimated time to complete activity: 1.6 hours
Full Disclosure Policy Affecting CME Activities
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any relevant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The participating faculty reported the following:
Course Directors
Benjamin Greenberg, MD, MHS
Assistant Professor
The Johns Hopkins University School of Medicine
Department of Neurology
Co-Director, The Johns Hopkins Transverse Myelitis Center
Director, The Johns Hopkins Encephalitis Center
Baltimore, Maryland
Dr Greenberg reports receiving grants/research support from the Accelerated Cure Project, the National Multiple Sclerosis Society, and Novartis Pharmaceuticals Corporation; serving as a consultant for DioGenix, Inc and Gene Logic Inc; and receiving honoraria from Biogen Idec and Teva Neuroscience.
Michael K. Racke, MD
Professor and Chairman of Neurology
The Helen C. Kurtz Chair in Neurology
The Ohio State University Medical Center
Columbus, Ohio
Dr Racke reports receiving grants/research support from the Bayer, National Institutes of Health, and National Multiple Sclerosis Society; serving as a consultant for Genentech, Inc, Peptimmune, and Teva Neuroscience; and serving on the speakers’ bureau for Bayer, Serono, and Teva Neuroscience.
Participating Faculty
Anne H. Cross, MD
Manny and Rosalyn Rosenthal and Dr John Trotter Multiple Sclerosis Center
Chair in Neuroimmunology
Professor of Neurology and Section Head, Neuroimmunology
Department of Neurology
Washington University School of Medicine
St. Louis, MO
Dr Cross reports receiving grants/research support from Biogen Idec and Genentech, Inc; serving as a consultant for Acorda Therapeutics, Biogen Idec, BioMS, and Genentech, Inc; holding stock in Affymetrix; receiving honoraria from Bayer Healthcare, Biogen Idec, Genentech, Inc, and Teva Therapeutics; and serving on the speakers’ bureau for Bayer Healthcare.
Off-Label Product Discussion: The audience is advised that a case in this CE activity contains reference(s) to unlabeled or unapproved uses of drugs or devices.
Dr Racke—rituximab for neuromyelitis optica.
All other faculty have indicated that they have not referenced unlabeled/unapproved uses of drugs or devices.
This activity was reviewed by Barbara Fitzsimmons, MS, RN, CNRN, for the American Nurses Credentialing Center’s accreditation purposes.
Disclaimer Statement
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing names implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.
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