MS Students' Guide for Academics
Tips for teachers on how to aid students suffering from Multiple Sclerosis
Each individual who suffers from MS will be different. For this reason it is important to be aware of gaps in your own knowledge and be understanding in your attitude towards students.
Common misconceptions about Multiple Sclerosis
It may be very frustrating for students who feel that others have a lack of understanding about their condition.
Though common for a variety of reasons, not all sufferers of MS will be noticeably physically disabled, or permanently disabled. Sometimes every day symptoms may go unnoticed and unconsidered such as poor coordination and balance. Furthermore though a student may be in remission this neither means that they are or are not still experiencing symptoms.
Fatigue and concentration particularly in working environments can be a major issue for those in remission or not, and this may commonly be cast aside as ‘laziness’. It is important to understand that this is why a sufferer may appear tiered and to take this into consideration.
Practical tips for enhancing learning experience
- If you become aware that a student suffers from Multiple Sclerosis, it is important to ask them about their limitations and any problems they may experience day to day. To avoid making the student uncomfortable, it is best to talk to them in private either after class or at a pre-arranged a time. Many students may feel uncomfortable in describing their situation without being prompted to first, and will appreciate you taking an interest in their condition and their learning. This will make the students feel a bit more confident about sharing their experience.
- Ask what and if there are particular things that you may do as a teacher to aid in their experience, it will also be a personal opinion depending on particular symptoms. For example, if the student has poor hearing they may like to rely more on facts in writing or eye contact in order to understand what is conveyed. Depending on physical abilities, it may also help to understand what works best for them in terms of recording information (typing, writing, audio recording etc.). Discuss with the student the assessments and requirements of the particular subject. Ask if they feel that any of the requirements might be an issue for them (for example handing in an assignment by the due date because of fatigue, or making a presentation with a severe body tremor or stutter as a result of increased anxiety levels). Try and discuss what both you and the student can do to aid in this situation.
- A very important aspect is making the learning environment a comfortable place. This can be achieved by making sure things are accessible with furniture arranged logically. For instance, if a student was in a wheel chair or with a walking aid, clear the room from the doorway so they are able to get through and find a place without problem. This will save the student feeling embarrassed or awkward. A lot of people may feel uncomfortable asking for help, so in preventing instances where assistance may be required will relieve stress.
Each person suffering from MS suffers from individual symptoms.
What is Multiple Sclerosis and what causes it?
As explained by the National MS society, multiple sclerosis (or MS) is a chronic, often disabling disease that attacks the central nervous system (CNS), which is made up of the brain, spinal cord, and optic nerves. It is considered to be an autoimmune disorder as the body’s own defence system attacks myelin, the fatty substance that surrounds and protects the nerve fibres in the central nervous system. The nerve fibres themselves can also be damaged. The damaged myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fibre is damaged or destroyed, nerve impulses travelling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms that can occur.
There is currently no known cure for MS, but there are a variety of treatments available for both the treatment of relapses (points during the disease in which a particular symptom lasts for over 24 hours) and the management of MS. All treatments have possible side effects (see common side effects)
Possible treatments of relapses (or exacerbations) include:
- Steroids (most common): The most common treatment regimen is a 3-5 day course of intravenous Solu-Medrol (methylprednisolone). High-dose oral Deltasone (prednisone) may also be used. Corticosteroids are not believed to have any long-term benefit on the disease.
- Intravenous immunoglobulin (IVIG): IVIG is a blood product which contains the pooled polyvalent, IgG (immunoglobulin (antibody) G) extracted from the plasma of over one thousand blood donors. IVIG's effects last between 2 weeks and 3 months. It is common for the use of autoimmune diseases.
- Plasmapheresis (Plasma exchange): Is a process in which blood is withdrawn from the person suffering a severe relapse which cannot be treated with steroids or IVIG. The bloods plasma is withdrawn from the person and replaced and then both the red and white blood cells re-enter the person. The process takes around 3-6 hours.
Treatments of the management of MS typically work to slow down the progression of MS by suppressing the immune system and lowering the attack of cells on the myelin sheath. These treatments can be administered in different frequencies depending on the drug and in a variety of ways including:
- Oral tablets
- Self controlled needles
For a list of the variety of medications on the management of MS see National MS Society
The Diagnosis of Multiple Sclerosis
Diagnosis of MS may be long and difficult due to the fact that each person suffering from MS suffers from individual symptoms, and it is therefore difficult to pin-point a common cause. People who are diagnosed with a clinically isolated syndrome (CIS) have had one episode of neurologic damage that is similar to the damage that occurs in MS, but they have not yet met the criteria for a definite diagnosis of MS. For a definite diagnosis of MS doctors commonly rely on:
- MRI scans that display lesions in the CNS
- At least two 'relapses' defined by CNS system damage that lasted over 24 hours
- A lumbar puncture (or spinal tap)
Facts about Multiple Sclerosis
- 2,500,000 people are estimated to suffer from MS worldwide
- MS effects women twice as much as it does men
- On average, the diagnosis of MS is between 25-40 years of age
- About 85 percent of those who are newly diagnosed have the relapsing-remitting form of MS
- No two people will experience the same symptoms
- MS is not contagious, and there is no known reason for the disease however in countries further from the equator, the incidence of MS increases.
Four different ‘courses’ of Multiple Sclerosis
- Relapsing Remitting MS: People with this type of MS experience clearly defined attacks of worsening neurologic function. These attacks—which are called relapses, flare-ups, or exacerbations —are followed by partial or complete recovery periods (remissions), during which no disease progression occurs. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.
- Primary Progressive MS: This disease course is characterized by slowly worsening neurologic function from the beginning—with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.
- Secondary Progressive MS: Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups, minor recoveries (remissions), or plateaus. Before the disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within 10 years. Long-term data are not yet available to determine if treatment significantly delays this transition.
- Progressive Relapsing MS: In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsening neurologic function along the way. They may or may not experience some recovery following these relapses, but the disease continues to progress without remissions.
MS is such a random disease that spans both the brain and the spinal cord.
Is it possible to detect in a student?
Because MS is such a random disease that spans both the brain and the spinal cord, it is impossible to pinpoint particular symptoms. The effects may also be relatable to other diseases so being able to label MS can be almost impossible. There are however some common found symptoms and side effects that with an understanding may make it possible to pinpoint the disease.
- Problems with sensation such as vision, touch and sound
- Cognitive dysfunction affecting memory, mood and concentration
- Muscle spasticity and weakness
- Poor balance and coordination
For a more extensive list and for more information see Symptoms & Diagnosis
Common Side Effects
Although MS symptoms are highly variable, common side effects due to both the condition and treatment of MS can be found. These include:
- Cold and flu like symptoms
About this Guide
This Guide has been written by University of Melbourne students.
It is intended to provide academics with a student perspective on how their condition affects their studies at the University.