Percutaneous endoscopic gastrostomy

(PEG) A PEG is a tube inserted into the stomach through the abdominal wall to provide food or other nutrients when eating by mouth is not possible. The tube is inserted in a bedside procedure using an endoscope to guide the tube through a small abdominal incision. An endoscope is a lighted instrument that allows the doctor to see inside the stomach.

Periventricular region The area surrounding the four fluid-filled cavities within the brain. MS plaques are commonly found within this region. See Plaques.

Physiatrist Physicians who specialize in physical medicine and rehabilitation, including the diagnosis and management of mus-culoskeletal injuries and pain syndromes, electrodiagnostic medicine (e.g., electromyography), and rehabilitation of severe impairments, including those caused by neurologic disease or injury. See Electromyography (EMG).

Physical therapist (PT) Physical therapists are trained to evaluate and improve move ment and function of the body, with particular attention to physical mobility, balance, posture, fatigue, and pain. The physical therapy program typically involves 1) educating the person with MS about the physical problems caused by the disease, 2) designing an individualized exercise program to address the problems, and 3) enhancing mobility and energy conservation through the use of a variety of mobility aids and adaptive equipment.

Placebo An inactive, nondrug compound that is designed to look just like the test drug. It is administered to control group subjects in double-blind clinical trials (in which neither the researchers nor the subjects know who is getting the drug and who is getting the placebo) as a means of assessing the benefits and liabilities of the test drug taken by experimental group subjects.

Placebo effect An apparently beneficial result of therapy that occurs because of the patient's expectation that the therapy will help.

Plantar reflex A reflex response obtained by drawing a pointed object along the outer border of the sole of the foot from the heel to the little toe. The normal flexor response is a bunching and downward movement of the toes. An upward movement of the big toe is called an extensor response, or Babinski reflex, which is a sensitive indicator of disease in the brain or spinal cord.

Plaque An area of inflamed or demyelinat-ed central nervous system tissue.

Post-void residual test (PVR) The PVR test determines how much urine is left in the bladder after an attempt to empty the bladder through urination has occurred. It involves passing a catheter into the bladder following urination in order to drain and measure any urine remaining in the bladder. The PVR is a simple, but effective technique for diagnosing bladder dysfunction in MS.

Postural tremor Rhythmic shaking that occurs when the muscles are tensed to hold an object or stay in a given position.

Prevalence The number of all new and old cases of a disease in a defined population at a particular point in time. The prevalence of MS in the United States at any given time is about 1/750: approximately 400,000 people.

Primary progressive MS (PPMS) A clinical course of MS characterized from the beginning by progressive disease, with no plateaus or remissions, or an occasional plateau and very short-lived, minor improvements. See Remission.

Prognosis Prediction of the future course of the disease.

Progressive-relapsing MS (PRMS) A clinical course of MS that shows disease progression from the beginning, but with clear, acute relapses, with or without full recovery from those relapses along the way.

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