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Yoga.pptx
1. MULTIPLE SCLEROSIS- A PRIMER
FOR THE YOGA PRACTITIONERS
Dr Venkatraman Karthikeayan
Consultant Neurologist
Dr Venkat’s Neuro Centre
2. Conflicts of interest
I have not received any grants or funds from the organiser or other
companies for this academic programme or any other research activity
3.
4. Introduction- Demyelinating disorders
Kuhn S, Gritti L, Crooks D, Dombrowski Y. Oligodendrocytes in development, myelin generation and beyond. Cells. 2019 Nov;8(11):1424.
9. 1395
First historical
description
suggestive of a
demyelinating
disorder in a 16
year old girl
Pearce JM. Historical descriptions of multiple sclerosis. European neurology. 2005;54(1):49-53.
12. 1860-70
Distinction
of MS as a
separate
Clinical and
anatomical
entity
Pearce JM. Historical descriptions of multiple sclerosis. European neurology. 2005;54(1):49-53.
13. 1894
Description
of NMO as a
distinct
entity
Jarius S, Wildemann B. The history of neuromyelitis optica. Journal of neuroinflammation. 2013 Dec;10(1):1-2.
14. NMO – a
variant of
MS
1930
Arias M. From Devic disease to the ‘neuromyelitis optica spectrum’: an unfinished tale bridging three centuries. Neurosciences and History. 2016;4(3):109-16.
16. 1395
First historical
description
suggestive of a
demyelinating
disorder in a 16
year old girl
1822
Best known non
medical
description of
MS 1835-50
Medical
description/
pathological
illustration of
MS
1860-70
Distinction
of MS as a
separate
Clinical and
anatomical
entity 1894
Description
of NMO as a
distinct
entity
NMO – a
variant of
MS
1930
1994
First DMT for
MS
17. Generation Z and Alpha in Demyelinating world
Multiple sclerosis
Can the existing symptoms be alleviated ?
Is multiple sclerosis completely curable?
19. Common Clinical Presentations
Visual loss (Optic neuritis and Field defects)
Transverse myelitis
Ataxia syndrome
Sensory syndrome
Cognitive syndrome
Other brainstem syndromes
24. The acute management and outcomes
No recovery Partially recovered Fully recovered
Outcomes
No treatment Steroids Plasma exchange
25. Life after a MS presentation
Weakness
Balance issues
Bladder and bowel issues
Visual symptoms
Numbness
Fatigue
Pain
Attention and memory issues
Anger and depression
V
I
S
I
B
L
E I
N
V
I
S
I
B
L
E
Disability
QOL
26. 26
Whatcanwedo
together
The care for MS is multidisciplinary
Neurologist Care giver
Physiotherapists
Psychologists
Yoga
practitioners
Care givers
PwMS
27. Some examples of Multidisciplinary management
MS symptom Pharmacological management Non Pharmacological management
Stiffness Antispastic medication Muscle stretches- Physiotherapy, Yoga, Tai-chi
Pain Neuropathic medications, opioid medications IFT,SWD, Yoga, Acupuncture, Tai-Chi
Bladder issues Anticholinergics Pelvic floor exercises, health education
Fatigue Neuramidinase inhibitors FACETS, Energy effectiveness, aerobic
exercises, Yoga
Cognitive issues Cognitive enhancers Cognitive retraining, CBT, Meditation
Mood issues Antianxiety and anti depression CBT, Yoga, Meditation
Gait issues Dalfampiridine Gait training, Yoga
31. Further course
Multiple Sclerosis can be conquered as a team and team only
Remember MS can be heterogenous and “no one shoe fits all”. The
treatment for MS is custom made.
The MS service can grow only with participation of multiple disciplines
Inclusive approach is the best way forward to reap the maximum
benefit from the multidisciplinary services
Evidence based approach works in liaison with the experience
Academic participation and research works are the need for the hour
Mapping Indian MS in the world Map will invite more funding
Highlighting each other and the organisations like MSSI will empower
the grass root strength and involvement
Take home messages
