1. CASE 1 Olivia Clements, Cade Mersch, and Julia Calhoun

2. Introduction of Patient Including Signs and Symptoms Symptoms of the Patient: tingling, fatigue, depression, vision issues, balance issues, muscle weakness, and come-and-go symptoms. To determine what disease she had, we researched common neuropathic diseases that share those same symptoms. After looking at multiple diseases, all of which were similar to the patient’s described symptoms, we came to the conclusion that the symptoms she was showing were also symptoms of Multiple Sclerosis.

3. Differential Findings Three possible diseases: Bipolar Disorder Peripheral Neuropathy Multiple Sclerosis

4. Bipolar Disease BPD is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of BPD that are shared with the patient are depression, tiredness, weakness, and the come-and-go of the symptoms. We concluded that, because there were many expressed symptoms that were not covered by BPD, the patient did not have this disease. Also, over half of all cases of BPD begin before the adult years, so the possibility that she developed this disease is unlikely.

5. Peripheral Neuropathy Peripheral Neuropathy refers to the conditions that result when nerves that carry messages to and from the brain & spinal cord are damaged. Common symptoms of Neuropathy shared with the patient are tingling and numbness, vision issues, and problems with balance. We concluded that, because there were some symptoms expressed that were not common symptoms of Neuropathy, the patient more than likely did not have this disease.

6. Multiple Sclerosis MS is a disease in which the myelin sheath covering the axon of a neuron is damaged, causing the signal transmission to be spotty, or non-existent. We researched a lot about this disease and its symptoms, and we concluded that the patient had MS. All of the symptoms that she was showing were part of MS. Tests used in diagnosis: MRIs of the brain and spinal cord (confirmation) Lumbar puncture (evaluates spinal fluid) Evoked potential testing (abnormalities: optic nerves and CNS)

7. Multiple Sclerosis Continued

8. Prognosis Multiple sclerosis will not affect Helen's longevity, as much as it will affect her quality of life. Except for extreme cases, patients with MS live normal lifespans and die of normal causes. Since there is no cure, Helen will have to contend with the symptoms of MS for the rest of her life. She will have to change her lifestyle, and physical therapy is recommended. MS can be unpredictable, but due to her early diagnosis Helen has a significant head start on treating her disease. With regular exercise, therapy, and prescription treatment, Helen will live a normal life only mildly affected by Multiple Sclerosis.

9. Errors in Communication The brain and spinal cord are severely affected.  Occipital Lode- impaired vision  Brainstem- can restrict certain body function  Parietal Lobe- memory loss  Cerebellum- can get a tumor MS happens when your immune system attacks a fatty material called myelin, which wraps around your nerve fibers to protect them. Without this outer shell, your nerves become damaged. Scar tissue may form. Your motor neurons can’t send the signals to move your muscles.

10. Biomedical Professions Neurophysiologist- A neurophysiologist is where it all starts for helping Helen. A neurophysiologist will assist a doctor in understanding how brain malfunctions occur, and what happens when they do. NPs are specialists that understand the relationship between the cognitive functions of the body, and the brain. Before Helen can be given treatment, a NP must first determine what is happening to her. Based on the symptoms that she experiences, and possibly some brain scans, A NP can create a diagnosis and prescribe the necessary treatment. Immunopathologist- After Helen is diagnosed with Multiple Sclerosis, an Immunopathologist is the next step to treatment. Multiple Sclerosis can't be cured, but a Immunopathologist can offer prescription drugs to help suppress the disease. Immunopathology is a specialized form of pathology that specifically deals with the immune system. With MS, the immune system eats away at the protective covering of the nerves. An immunopathologist will most likely suggest the patient to take steroids like Medrol, or other prescriptions that suppress the immune system. This also comes with obvious risks of its own.

11. Biomedical Professionals Continued Physical therapist- Helen reports dizziness, loss of balance, fatigue, and weakness. All of these symptoms, caused by multiple Sclerosis or not, can be effectively treated by a physical therapist. A PTs goal is to bring a patient back to good physical health. They do this by creating a care plan based on the diagnosis of a patient (perhaps created by a neurophysiologist). PTs guide patients through exercise, specifically focusing on the areas that they may be weak in depending on what afflictions they may have. Helen will probably have to see a physical therapist for the rest of her life.

12. Treatment There is no known cure for multiple sclerosis at this time. But, there are treatments that may slow the disease. The goal of treatment is to control symptoms and help you maintain a normal quality of life. Examples  Steroids to decrease the severity of attacks  Medicines to control symptoms such as muscle spasms, urinary problems, fatigue, or mood problems  Physical therapy, speech therapy, occupational therapy, and support groups  A planned exercise program early in the course of the disorder  Vitamin D or other supplements  Reduce stress

13. Sources Bipolar Disorder. (2014). Retrieved October 8, 2015, from http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml Multiple Sclerosis (MS) Exams and Tests for Diagnosis. (2015). Retrieved October 8, 2015, from http://www.webmd.com/multiple-sclerosis/tc/multiple-sclerosis-ms-exams-and-tests Multiple Sclerosis. (2015). Retrieved October 8, 2015, from http://www.brainfacts.org/diseases- disorders/diseases-a-to-z-from-ninds/multiple-sclerosis/ Peripheral Neuropathy - Symptoms, Types and Causes of Peripheral Neuropathy - from WebMD. (2015). Retrieved October 8, 2015, from http://www.webmd.com/brain/understanding- peripheral-neuropathy-basics Benefits of Physical Therapy for MS. (n.d.). Retrieved October 8, 2015, from http://www.webmd.com/multiple-sclerosis/guide/multiple-sclerosis-physical-therapy ExploreHealthCareers.org. (n.d.). Retrieved October 8, 2015, from http://explorehealthcareers.org/en/career/70/physical_therapist Department of Pathology. (n.d.). Retrieved October 8, 2015, from http://path.upmc.edu/divisions/clinimm.html Neuropsychology Careers. (n.d.). Retrieved October 8, 2015, from http://careersinpsychology.org/becoming-a-neuropsychologist/