1. The MS Clinic Alastair Lansbury Neurologist

2. What is MS ? Inflammatory Central Nervous System Autoimmune Relapses and remission (Progressive forms) Any central nervous system symptom or sign

3. Case Study 27 year old woman 4 years ago - 2 days of painful loss vision R eye. Resolved over 3 weeks. Diagnosis optic neuritis 2 week history of weakness, numbness R side and slurred speech

4. The aims of the service Diagnosis Support Information Identification and treatment of relapses Identify those suitable for DMDs Monitoring of DMDs Symptom control

5. Diagnosis History Examination Investigation

6. Investigations MRI Scan Lumbar Puncture Exclude other causes

8. Communicating the diagnosis Guidelines for breaking bad news. Swift review Information Support

9. The multidisciplinary team MS nurse Physiotherapist Occupational therapist Speech therapist MS Society Psychology Palliative Care Neurologist

10. Symptom management in Multiple Sclerosis Spasticity –Non-medical –Drug treatment –Intrathecal therapies

11. Symptom management in Multiple Sclerosis Fatigue –Fatigue management strategies –Drug treatment Amantadine Modafanil

12. Symptom management in Multiple Sclerosis Pain Bladder problems Sensory symptoms Mobility and dependency Management of relapses Speech and communication Cognitive problems Emotional and psychological support Employment and Finance